As we are all aware that there is an explosive outbreak of H1N1 swine flu infection in India. The high risk groups are pregnant women, people above 60 years of age, infants and children. I would recommend you the following to keep yourself protected and also help in stopping the spread of infection:

1) If you have fever and cough, seek immediate treatment. Insist on testing for H1N1 and take Tamiflu as per results.

2) Use handkerchief when you cough. Cover your mouth and nose to prevent spread to others.

3) Isolate those patients who are positive for H1N1.

4) Eat healthy food and exercise daily to keep your immunity intact.

5) Vitamin C is a good immunity booster for viral infections.

6) Avoid travel to areas where there is an outbreak.

7) Use N95 mask for protection - especially nurses and other health care workers who deal with positive patients.

8) Get yourself vaccinated with influenza vaccine - especially those who are in the high risk group.

If you have any more questions, please contact me.

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Act before swine flu strikes you down!

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

Diabetes is a metabolic disorder characterized by Hyperglycemia (elevated blood glucose level) due to either reduced production of insulin or the inability of the body to utilize the insulin produced. Today management of diabetes has become a prime concern. Over the winter months, diabetic patients are likely to suffer from higher blood glucose levels than during the warmer months. As the temperature drops and the sugar levels up, thus, diabetic patients should be extra careful about the temperature fluctuations or seasonal changes.The cold weather makes diabetics experience many health problems, besides creating a major change in their sugar levels.

Following are the most harmful effects that diabetic patients may suffer from during the cold weather

Change in hemoglobin level: There is a great change in their glycated hemoglobin levels. Whatever the type of diabetes an individual has, the freezing temperature can increase the level of HbA1c or glycated hemoglobin. This is most likely because of decreased physical activity. Cold weather makes it difficult for some people to go out. A little activity each day can help with insulin sensitivity (in all types of diabetes) which can help the body to regulate sugar level in a better way.
Prone to diseases: Since the immune system is also not at its best strength in winters, there are increased incidences of microbial infections like cold and flu or in some cases pneumonia. As a result, the body produces counterregulatory hormones (Cortisol, Adrenaline, and Glucagon) to counteract the situation. These hormones affect the utilization of insulin by the body thereby elevating the blood glucose level. Also, conditions like flu and cold tend to make them feel lethargic and stress and can prevent them from taking the diet, which is required, which eventually can lead to an increase in the blood sugar level.
Winter blues: It is often seen that people feel low during winters, as they tend to go out less and prefer to stay indoors. Less outdoor activity during winters can sometimes trigger mood swings or in some cases depression, which in turn can shoot up the level of blood sugar in their body. Thus it is advisable that one should spend more time with friends and family, in order to keep these blues at bay. 
Other problems: Most diabetic people are unaware of their nerve functions, and are unable to feel the difference between the cold and hot water, which can lead to burn injury. Also, during the winter season, most diabetic patients tend to lose feeling in their toes and feet due to vascular changes. Therefore, it is advisable that people should check their feet frequently, so as to ensure that there is no open wound or pressure area in their feet. One must take very good care of their feet, keep them moisturized, inner fingers clean and dry, prevent any type of fungal growth in toes, etc. By taking required preventive measures before the onset of winters diabetic patients can control their blood sugar level, which enables them to stay away from associated problems. 
In case the blood sugar level goes beyond 130, one should not take the medicine on their own but should get in touch with their endocrinologist (diabetologist).

Cold Weather - How It Can Affect Diabetic Patients?

Food allergy is actually an abnormal response triggered by the immune system to food as if it is threatening. Food intolerance looks similar to food allergies. However, the difference lies in how each one of them affects an individual. Food allergy is extremely intrinsic and to an extent, affects the internal organs. 

On the other hand, food intolerance is less severe, mostly just affects the digestive system due to the inability to digest that particular food properly, leading to an upset stomach. Most of the people suffer from food intolerance only, but they confuse it with food allergy.

About ninety percent of all cases of food allergy are related to only eight types of food as per research statistics. These are milk, tree nuts, egg, peanut, soy, wheat, shellfish, and fish.

The Reaction:\

In order to understand how symptoms manifest, it is of utmost importance, in this case, to understand how an allergic reaction to food occurs. An allergic reaction is a bi-step process as discussed further.

Step1: On exposure to the food allergen for the first time, the body reacts abnormally and produces IgE antibodies against the perceived allergen. These circulate throughout the entire body with blood and attach themselves to basophils (found in blood) and mast cells (found in sites like the nose, lungs, throat, gastrointestinal tract, skin, etc.).

Step 2: The next time the body is exposed to a particular food allergen, it gets alert and alarms the tissue that releases histamine in large quantity. Depending on the site of release, allergy symptoms are caused, ranging from mild to severe to potentially life-threatening (for example, in anaphylaxis).

The time span for an allergic reaction manifesting into symptoms can vary between a few minutes to several hours post exposure to the food allergen. The site of mast cells for release of histamine greatly affects the location and timing of the reaction.

Who is at Higher Risk?

If a person has a family history of developing a food allergy, it creates even greater chances for him/ her to have the same or similar reactions. If both the parents have some kind of allergic reaction to food, it is very likely that the child would have that too.

Symptoms:

Symptoms of food allergies largely depend on the sites of mast cells that release histamines. It is possible that these sites are located in nose, ears, or throat leading to itching in mouth, having a trouble in swallowing and breathing, and swelling of lips and tongue. If the location is in the gastrointestinal tract, it may lead to vomiting, diarrhoea, and abdominal pain. If it is in the skin, it might lead to hives, itching, decolourization, pigmentation, worsened eczema, etc.

Cross Reactivity:

If a person has an allergy to a particular food, it is advisable to abstain from similar types of food. For example, if somebody is allergic to crab, he/ she should abstain from shrimp, crayfish, lobster, etc. too as they might also trigger the reaction. This is called cross reactivity.

Treatment:

It is always advisable to abstain from foods which cause an allergic reaction in an individual. However, in case it has already occurred, there are two major types of medication which help in relieving the symptoms. Antihistamines are used for treating mild to chronic reaction, whereas adrenalines are used for severe reaction like in anaphylaxis.

Take Away:

Food allergy is usually a condition for life and cannot be permanently treated. However, symptoms can be relieved. Therefore, it is advisable to avoid the allergy, causing group of food.

Food Allergy - Everything About It!

Pregnancy is a life-changing phase in a woman s life. In addition to a baby (or babies!), there are a lot of physical and emotional changes also that come with it. The more evident are the physical ones, and in addition to weight changes, the stretch marks are the most obvious.

The uterus or the womb grows to its full extent to accommodate the developing baby, and so there is stretching of the connective tissue in these areas. After delivery, the tension is lost, and these marks become evident.

What are stretch marks?

These marks appear as lines on the skin and are most commonly found in areas such as the buttocks, arms, breasts, thighs and stomach. They are different in appearance in comparison to the normal skin. It may appear pinkish or purplish initially and then it takes a shiny appearance later. When you feel the stretch marks, you may feel a certain indentation or ridge on the skin. It may feel sore or itchy as well sometimes.

They most commonly appear during adolescence when there is rapid growth and stretching of the skin. It is also seen in women pre and post pregnancy. Stretch marks can also appear when there is a sudden change in weight.

How To Treat Them?

Use Moisturisers: People who use moisturisers show an increased elasticity of the skin, which reduces the appearance of stretch marks on the skin. Keeping the skin hydrated stops the skin from tearing and creating stretch marks. Moisturising is not entirely effective on older marks, but it can help with newly formed stretch marks. You can also use it on areas that are prone to stretch marks.

Retin-A: Retin- A is known to boost collagen production that helps the skin to stretch out with ease and not cause tears. When Retin-A is used, it is recommended to limit the sun exposure as the skin becomes more susceptible to sun damage and burning.

Glycolic Acid: This chemical compound falls under the category of an alpha-hydroxy acid which is commonly found as a major ingredient in chemical peels. It is known to amplify the production of collagen and increase the tensile strength of the skin. Go to your dermatologist for a stronger dose for more effective results.

A Combination of Retin-A and Glycolic Acid: A combination of these two potentiates the action of each other and gives better results.

Vitamin E Oil: You can find Vitamin E oil capsules in medical shops that are known as the miracle medication when it comes to curing stretch marks.

Essential Oils: Certain essential oils like rose oil, lavender oil, or geranium oil are known to reduce stretch marks.

Vascular Laser: Pulsed dye laser that is kept at the wavelength of 585 nm is used to remove the stretch marks that are red and newly formed. It may not be effective on the older ones that have turned silver. This process is highly expensive and needs about 6 sittings. The efficacy of this procedure also depends on the complexion of the skin. Much like laser hair removal, vascular laser does not work on darker skin. The colour difference between the marks and the actual skin tone should be prominent.

Fractional Laser Treatment or Laser Resurfacing: This is used to get rid of the older stretch marks that have turned light and are no longer red. This procedure is more expensive than the previous one and is prone to leave scars on the site of application.

Abdominoplasty or Tummy Tuck: The only permanent solution to get rid of stretch marks is to cut them out entirely. If you are tired of the stubborn tiger stripes, then this could be your only way out.

RF Micro-Needling Device: This is a more cost effective alternative to CO2 Laser Resurfacing that could be used on any stretch mark types  new and old . The micro needles are driven directly into the skin to a certain depth (0.2mm-3.0mm) and radiofrequency (RF) energy is then released inside the skin. Minimally invasive RF thermal energy creates fractional electrocoagulation in the dermis which facilitates a natural wound healing process promoting the remodelling of collagen.

10 Tips To Treat Stretch Marks Effectively

Chicken VS Egg- Which has more protein?

Protein comes in ample amount from foods such as meat, eggs, legumes, dairy products, soy, and fish. It serves as the building blocks for the body's cells, muscles, skin, tissue, and organs.
Although, both chicken and egg are infused with high amounts of protein, they do vary on the grounds of the actual protein content per serving.  So which is a better source of protein?

Nutritional facts of 100g chicken 

Protein:  27g
Fats: 4g
Calories: 153
Sodium:  51mg
Cholesterol: 75mg

Nutritional facts of 100g eggs

Protein: 13g
Fats: 11g
Calories: 155
Sodium: 124mg
Cholesterol: 373mg

Both chicken and eggs are a low calorie and high protein option.  However, chicken contains double the amount of protein than eggs per serving, emerging as a clear winner. Not only that, chicken also contains less cholesterol in comparison to eggs, making it a much healthier food choice.

Nevertheless, eggs possess a number of other health benefits, and should not be ruled out of your daily diet. 

1. Eggs contain riboflavin or Vitamin B2 in abundance, which helps in improving your metabolism
2.  Egg whites are a rich source of  Vitamin D, B6, B12 and minerals such as zinc, iron, and copper, all of which are essential for the proper functioning of your body
Even though both chicken and eggs are almost equally healthy, the key to proper health is to eat all you want but in a moderate manner.

If you would like to consult with me privately, please click on 'Consult'.

Chicken VS Egg- Which has more protein?

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