There may be times when we get completely drained and fatigued and may feel like our insides could jump out because of the pain that we have in our stomachs. We may dismiss the issue as unimportant or due to a stressful day at work, and may think the stomach pain could be because of the extra spicy food we love to have every once in a while. However, a lot of people may tend to ignore this symptom and that is when stomach ache may turn out to be actually because of a peptic ulcer.

Peptic ulcer or stomach ulcer is a common occurrence and happens to a lot of people; however, it must be understood that not treating the problem in time may be troublesome in the long run and increase the recovery time. In order to be able to identify the peptic ulcers and to take the right treatment measures, it may be important for you to understand the problem and know how it is caused, and how it may be treated.

What causes peptic ulcers?
A peptic ulcer is diagnosed as inflammatory sores on the lining of the stomach or the food pipe, which transfers food to the stomach or even in the intestine. There are a number of factors that can cause inflammatory sores in the stomach region. The factors are as follows:

    The use of medicines that are meant to be painkillers or anti-inflammatory drugs. The acid levels of the stomach and the food pipe may get disturbed because of these medicines and may give rise to ulcers.
    In a lot of cases, the ulcers may also take place because of the presence of a tumour or a gastrinoma in the stomach that imbalance the levels of acid in the stomach.
    High alcohol consumption may also lead to the formation of sores on the stomach lining.
    Using tobacco or smoking are some other factors that contribute to the acid imbalance in the stomach.
    In the case of some serious illnesses, a lot of people may fall prey to peptic ulcers.
    Those who may have undergone radiation treatment around the stomach may also experience ulcers.

Though it may be known that excessive pain in the abdominal region may be due to stomach ulcers, it is important to understand that it happens due to bacterial infections, and when there is a bacterial infection in the body, you may have to undergo proper treatment. The treatment for this problem includes the use of medications as suggested by a qualified doctor, surgery in some severe cases, and most importantly lifestyle changes.

Peptic Ulcer - 6 Reasons Behind it

From marathon runners to footballers, amongst athletes, 'pulling a hamstring' is the most common type of injury. The hamstring is a group of four muscles at the back of your thigh. When one of these muscles gets overloaded or begins to tear, it is known as a hamstring injury. While a hamstring injury is painful, it does not indicate the end of an athlete's career.

Minor hamstring injuries may heal by themselves. In cases where one of the muscles is torn, surgery is required to repair and reattach the muscles. Recovery time depends on the severity of the injury. Stretching and exercising the muscles of the leg are the most important parts of rehabilitation. The healing of a hamstring injury can be divided into four stages.

1. Acute phase: The first five days after a hamstring injury is known as the acute phase of rehabilitation. The aim of treatment at this phase is to reduce inflammation and keep the other muscles from atrophy. For minor hamstring injuries resting the leg, using ice packs and keeping the leg elevated can accelerate the healing process. Once the pain and swelling has decreased, patients can use a cane or crutch to exercise the leg.

2. Subacute phase: From the fifth day to the 3rd week after the injury, the focus of the treatment shifts from minimizing swelling to strengthening the leg and increasing the range of possible motions. At this time, an athlete can resume cardiovascular training. Swimming and other forms of aquatic training are said to be especially beneficial to the treatment of hamstring injuries.

3. Remodeling phase: The remodeling phase continues upto 6 weeks after the injury. Strengthening the leg is the focus of this stage of treatment. Using ankle weights can be beneficial towards strengthening the leg muscles. It is important to be careful about the weight being used and to gradually increase this weight to avoid an added injury.

4. Functional stage: This stage can last upto 6 months until the athlete can regain full function of his or her leg. As the athlete's gait gets back to normal, they may start jogging and short sprints. Gradually, more sport specific exercises may be added to the workout.

There is no fixed time when an athlete can return to active sports after a hamstring injury. While players with minor injuries may return to the field after 3 weeks, athletes with muscles tears may take upto 6 months to recover completely. Hamstring injuries tend to reoccur and hence before they can get back to active sports, an athlete must pass an isometric strength test and flexibility test. This ensures that there are no subtle after effects of the injury that can increase the risk of a repeat injury.

Hamstring Injury Recovery and Return to Sports

What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Dandruff is also known as Seborrhea, the white flakes that you may notice on your scalp or skin. It is generally caused due to dryness. Dandruff can only be controlled and not absolutely cured. It can give rise to other skin problems as well. The following are the ways in which your skin may be adversely affected due to dandruff

Pimples may pop out: Due to dandruff pimples may pop out on your skin. If the white flakes fall on your T- zone region, the facial area which is more prone to pimples.
Problem of pigmentation: The pimples leave behind dark spots all over your skin leading to the embarrassing problem of pigmentation. Dandruff makes the condition even worse.
Chest rashes may appear: If your dandruff becomes uncontrollable then it keeps falling all over your body. This may lead to the break out of chest rashes.
Acne: Acne is another distressing problem that may be the result of dandruff. This also promotes the break out of pimples and red rashes on your skin.
Facial rashes: Facial rashes may also appear in many cases. Rashes can be seen near the eyebrow or forehead region. In case of men, beard rashes are also common.
Itchy scalp: Dandruff gives you an itchy scalp. This further makes the condition of dandruff worse and the skin of your scalp becomes scaly resulting in further problems.
Eczema and psoriases are unfavorably affected: Skin problems like eczema and psoriases become far worse due to dandruff.
Inflammation and redness: Dandruff may cause your facial skin to suffer from the problems of inflammation and redness.
It is highly recommended for you to use natural remedies and good hair care products to control your dandruff so that your skin is not much affected. But if it is uncontrollable, visiting a dermatologist is a must.

How Is Dandruff Affecting Your Skin?

The HIV (human immunodeficiency virus) is a critical disease. This virus invades a person's immune system which is the body's defense against infections such as viruses and bacteria. The immune system doesn't work properly and becomes deficient once attacked by HIV. One social acknowledgement to HIV that has gained enough recognition is the HIV counselling due to the crucial need to counsel the patient about sexual behavior and the risks associated with it. 

Importance of HIV counselling 
The human immunodeficiency virus has become an epidemic in nature and has reached to a distressing proportion worldwide as it is in its third decade. Thus, counselling becomes remarkably crucial part of the treatment. 

HIV prevention counselling is a significant mode of behavioral invasion particularly in the deficiency or lack of an effective curative treatment or vaccine. HIV counselling varies from other forms of counselling sessions. Apart from being a health obstacle, the disease is equally overwhelming for the family as well as people around you. family. It is also connected with endless and intense human suffering which stimulates multiple emotional responses. Such reactions involve self-denial, grief, fear, loss, anxiety, anger, annoyance, depression self-blaming, pity, self-condemnation isolation and suicidal thoughts. 

Also, the risk of passing the virus to the partner during sexual activity is high and the patient must be aware of safe sex and the risks associated with unprotected sex. Hence, counselling becomes paramount. 

Counselling session s information Self-care counselling: 
The patient must be well informed about the disease and should be supported in embracing attitudes, actions, and beliefs which will defend and serve as a protective shield to the body s immune system. Improving, enhancing, and transforming nutrition is required. A few other things that are emphasized are, encouraging physical activity, avoiding objects, actions, and events that threaten the body, overcoming anxiety and stress that compromise the psychological, mental, physical and welfare of the body, and seeking and giving support for self-care. 

Types of counselling: 

Patient centered counselling: It changed the focus of counselling from a single informative one to one that concentrated on a patient s circumstances and needs. This involved active listening, to render better support and managing client's particular prevention needs. 
Risk reduction counselling: This includes examining client s awareness about sexual activity and their feelings.Using their current HIV knowledge as an appealing tool, the limitations they have for protected sex is discussed. A better understanding is ensured in the patients so that unsafe behaviors can be avoided. 
Grief counselling: People who are contaminated with HIV have an elevated risk of acquiring depression. Counselling helps you to deal with any emotional outburst. 
Aims of counselling in HIV infection-

Prevention is the first purpose of HIV counselling. It decides whether the lifestyle puts that individual at a higher risk. Helping to recognize and distinguish the definitions of high-risk behavior. The counselling contributes to behavioral change and also aims at working with the person and his family to obtain and sustain that change in approach and behavior.

HIV Counselling - Why It Is Important To Get It?

Chronic Diarrhoea is a condition that results in watery or loose stools. While most diarrhoea subsides within a few days time, the chronic ones persist up to a couple of weeks. Some common symptoms that can help to identify chronic diarrhoea include bloating, nausea, fever, blood in the stool, abdominal cramps etc. Here is a brief look at the possible causes of chronic diarrhoea:

What are the possible causes of chronic diarrhoea?
Parasites and bacteria: Parasites and bacteria are often transmitted from contaminated food and water. Certain parasites such as the cryptosporidium and Giardia lamblia can lead to chronic diarrhoea. Some common bacteria include Escherichia coli, Campylobacter, Shigella, and Salmonella. In the more developed countries, diarrhoea is often referred to as the traveller s syndrome. Diarrhoea can also result from a course of antibiotics due to an infection from Clostridium difficile.

Viruses: Some of the common viruses that can lead to chronic diarrhoea include viral hepatitis, Norwalk virus, and cytomegalovirus. A certain virus known as the Rotavirus can lead to an acute childhood diarrhoea.
Medication: Certain medication is known to be the culprit when it comes to causing diarrhoea. Antibiotics, for instance, tend to equally destroy both the good and the bad bacteria thereby disturbing the bacterial balance of the intestine leading to chronic diarrhoea. Certain other drugs related to cancer, antacids containing magnesium etc can also lead to chronic diarrhoea.
Artificial Sweeteners: Certain artificial sweeteners are known to be causing chronic diarrhoea. Compounds such as Mannitol, Fructose etc found in certain sugar-free products or chewing gum can lead to chronic diarrhoea in otherwise healthy people. It is, therefore, advised not to consume too many artificial sweeteners in excess at one go.
Intolerance of lactose: Lactose is a type of sugar that is mostly found in dairy products. People who find it difficult digesting this compound often tend to suffer from diarrhoea when they consume dairy products. Our body produces an enzyme to digest lactose. However, this enzyme tends to rapidly feds away from the body with age. Lesser the amount of this enzyme, greater is the chance of lactose intolerance leading to an increased risk of chronic diarrhoea.
Surgery: There are surgeries that can begin the onset of chronic diarrhoea. Certain procedures such as the gallbladder removal surgery and abdominal surgery run a high risk of chronic diarrhoea.
Fructose: For people who find it hard to digest fructose can suffer from chronic diarrhoea. Fructose is a naturally occurring sweetener found in honey, fruits etc and is often added to beverages to enhance the taste.
Certain digestive disorders: Certain other situations such as celiac disease, microscopic colitis, Crohn s disease, ulcerative colitis irritable bowel syndrome etc can lead to chronic diarrhoea. 

Chronic Diarrhoea - What Causes It?

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