It's International Women s Day yet again. A time to celebrate women s accomplishments- both those of legendary creators including Mother Teresa, Kiran Bedi, Anuradha Koirala   the anti-sex-trafficking activist & Mary Kom to name a few and the women in our lives who mentor and inspire us every day. It s a day to celebrate our journey towards gender equality and women empowerment.

This year s International Women s Day theme is  Time is Now: Rural and urban activists transforming women's lives.  It comes on the heels of unprecedented global movement for women s rights, equality, and justice. The theme has taken the global campaigns and marches on issues ranging from sexual harassment and femicide to equal pay and women s political representation.

Women still have a long way to go to attain equality and non-discrimination from her male counterparts. 2018 International Women s day is an 'iron in the fire opportunity' to bring a call to action to entrust women with what they actually deserve, not only in a particular sector but to every woman who resides in urban as well as rural areas. It is a step to respect and appreciate the women who step out every day for the livelihood of their families and kids - a step to stop casual sexism faced by urban women in the workplace.

Women, experiencing sexual harassment in the workplace, not only bear strained relationships with their counterparts but also are at risk of numerous health problems. Let us know about the health effects of sexual harassment:

Depression: Self-doubt and criticism can lead to depression and loss of interest in work or other activities. Women also experience loss of self-confidence and feelings of failure & powerlessness.
Anxiety: Many women feel anxious about going to work, communicating with co-workers or being involved in social situations.
Insomnia: Sexual harassment trauma can cause nightmares and may lessen the woman's ability to sleep properly.
Post-traumatic stress disorder (PTSD): Studies say that sexual harassment meets the Criteria A1 and A2 of PTSD. The stress of sexual harassment may cause a woman to relive the trauma even when it is not happening, or avoid things or people that remind her of the sexual harassment.
The International Women s Day echoes a word for transforming the lives of women with a bold determination not just on papers but in reality to support the women all around the globe. Many working women have sad tales to tell as they are exploited at a very high level, and they actually lead a stressful life in comparison to their male counterparts.

So, the spotlight this year is to fight against the injustice that most women face every day and to bring about a change that will be remembered for years and will outshine the lives of such women who devote themselves for the livelihood of their families.

Join a campaign, embrace your inner activist and empower the women in your life...

The #TimeisNow To-

Raise your voice
Support each other
Share the workload
Get involved
Educate the next generation
Know your rights

#TimeIsNow - This International Women's Day, Empower The Woman In Your Life! 

Depression is a clinical, mental, and emotional condition that may give rise to feelings of hopelessness and chronic sadness. It slows down the way people process everyday activities and leads the patient to a sense of constant gloom and doom. It is a disabling mental condition as per who, and may be caused due to reasons like genetics, changes in the balance of hormones, stress, grief, trauma and prolonged, chronic physical ailments. Depression is also connected with food and nutrition. Do you want to know how? 
Read on to see the three ways in which food and depression are connected. 

1. Severity and duration: depression is a mental illness that signifies an imbalance in the hormones and the emotional faculties in the brain. Nutrition is the fuel that keeps the brain and body in prime working condition. When a depressive state sets in or becomes emotionally rooted, then nutritious eating and a proper diet take a back seat as the patient succumbs to a state where he or she is not concerned about the food intake. As a result, the brain and hormonal balance get further affected. This can have an adverse effect on the severity and the duration of the depressive mode, which makes it all a vicious cycle of sorts. Poor appetite, not having proper meals, skipping meals, eating junk, avoiding social settings where food will be served, and even emotional eating are all outcomes of depression too.

2. Eating disorders: many patients who have eating disorders often experience deep rooted and chronic depression. Since despondency and hopelessness are the main characteristics of depressive behaviour, the outcome is that the patient tries to behave in a way that seeks approval. And in all this, the patient usually thinks that he or she is not'good enough. In such a scenario, the patient may start trying out fad diets and eventually fall prey to eating disorders like bulimia that make the patient overeat and then vomit. These eating disorders usually come with phases of binge eating, throwing up, starving and then repeating the cycle again. Eating in secrecy is also a symptom of this condition.

3. Nutrition to fight depression: nutrition and proper food intake can build a sense of resilience by first of all improving the overall physical condition of the patient. This can take care of a lot of angst even as the minerals and vitamins travel to the brain for better functioning in the long run.

Ensure that you eat right as a part of your therapy for depression. This is as good as taking your medication on time!

Three Ways Depression Is Connected With Food

What do we mean by a hiatal hernia?

The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.

What does statistical data say about a hiatal hernia?

Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.

In which age group is hiatal hernia very common?

The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50. 

What are the causes of hiatal hernia?

The most common risk factors are as follows: 

Obesity Congenital deformities, such as scoliosis
Certain types of surgery
Major trauma
Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?

There are four types of a hiatal hernia and they are as follows:

Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?

Common symptoms include:

Heartburn
Chest pain or epigastric pain, coughing
Difficulty in swallowing
Belching, eructation, and hiccups
How to diagnose the condition?

To diagnose this condition following tests or procedures are included:

X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?

It includes medications and surgery which are as follows:

Antacids to neutralize stomach acid and to reduce acid production
Medications that heal the esophagus 
Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter

Hiatal Hernia - How Is it Diagnosed?

5 Unexpected Triggers of Hair Fall

Your genes may be the most common triggers of hair fall, but in certain cases hair fall can be triggered by a host of other reasons you wouldn t have thought about. Sometimes these reasons can range from being simple and temporary (lack of essential nutrients in your diet for example) to something more complex and indicative of an underlying health problem. Read on...

1. Brushing wet hair

Detangling wet hair (easy at it may seem) is probably one of the most common triggers of hair fall. Wet hair is extremely delicate, and brushing wet hair causes the strands to break, leading to excessive hair fall. Repeatedly doing so can cause your hair to become thinner over time, which may result in visibly less hair on your scalp.

2. Food poisoning

Food poisoning can cause an abnormality in your blood circulation, which, as a result, can lead your hair to prematurely enter into a shedding phase. The hair loss that takes place due to this reason is known as  diffuse hair loss.  This type of hair loss usually lasts for a period of 3 months, after which, the hair follicles are replaced by new ones. Hair fall caused by food poisoning is only temporary, and is corrected on its own with time.

3. Car crashes or any other traumatic events

When you go through a car crash or any other traumatic incidence for that matter (divorce, death in the family etc), you may experience an extreme form of shock. This can lead to the development of small bald patches on your head, which is known as Telogen Effluvium. Usually, trauma triggers an autoimmune reaction, because of which the white blood cells attack the hair bulb. This causes the hair bulb to enter into the resting phase, which leads to mildly painful hair loss in particular patches. This type of hair fall is reversible.

4. Food allergies

Different foods (such as dairy, wheat, soy etc) can cause allergies in different people. Such an allergic reaction can cause your immune system to react violently, consequently making your immune system send signals throughout your body to ward off attacks. This, in very rare cases, can give rise to the condition of Alopecia Areata, as your immune system detects the growth of your hair as foreign attack and sends off signals to destroy hair follicles. This type of hair fall ceases once you stop consuming food(s) you re allergic to.

5. General Anaesthesia and Surgery

Hair fall triggered by general anaesthesia and a major surgery usually shows up 3 months after the surgery has taken place. The combination of general anaesthesia and a major surgery can put your body under heavy physical stress, which can cause alterations in the life cycles of the hairs on your scalp, consequently leading to excessive hair fall. Hair fall caused by this reason is temporary too, and usually your hair will grow back over time.
Now that you know about the possible triggers of hair fall, you may be in a better position to control your condition and prevent your hair from falling out. 



5 Unexpected Reasons Why You Might Be Losing Your Hair!

Post-traumatic stress disorder (PTSD) is an abnormal condition of the mind that develops when a person is exposed to certain traumatic events in life such as accidents, sexual assault or warfare.

The major symptoms of PTSD are:

Reliving the traumatic experience over and over again; this leads to severe and long-term mental distress.
Recurring dreams about the events.
Provocation of traumatic thoughts by the slightest event that causes distress to the individual.
Avoiding memories and thoughts that might remind them of the event.
Developing a negative view of themselves and the world.
Developing social or specific phobias.
Treatment

Medication and antidepressants: Medicines such as paroxetine, sertraline and selective serotonin reuptake inhibitor (SSRI) help the individual address insomnia related problems that occur due to PTSD and suppress nightmares.
Psychotherapy: This form of therapy is used to cure both mental health conditions (such as obsessive compulsive disorder, anxiety and depression) as well as emotional problems that result from PTSD. Skilled mental health experts are needed for this form of treatment to be administered. They would listen to each individual patiently and provide effective strategies to give solutions to the problems. Some of these therapies are:
Cognitive Behavioural therapy: This therapy enables the individual to adapt to changes and recognize thought patterns which lead to irrational and negative behaviour and actions.
Exposure therapy: This therapy causes the affected individual to first become anxious by exposing him/her to the traumatic memories, situations and objects by simulating them. The therapy helps the person to overcome his/her fears and become comfortable in the same environment that had previously caused fear and anxiety.
Group therapy: This popular and effective form of therapy allows the individual to share his/her feelings, fears and thoughts with a group of people who have themselves experienced similar trauma in their lives. Sharing such experiences helps reduces stress levels.
Some Self-Help and Coping Tips include:

Avoiding situations that cause PTSD can worsen the condition. Hence, the individual should try to embrace and face such situations boldly.
PTSD can result in loss of motivation and stress. Try utilizing your time in socialising, indulging in certain or even exercising for that matter.
Taking some time out to relax and having fun is very important. This calms the body and mind, thereby improving one s mood.

PTSD - 6 Major Signs + Treatment

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

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