An abnormal swelling in the neck can be symptom of various problems. While it can be something as non-threatening as a swollen gland due to a cold that can be cured with simple medication, a swollen neck can also turn out to be a cancerous lump in the neck. When faced with an irregular swelling in the neck, it is best to not panic or jump to conclusions until you consult with an Ear-Nose-Throat Specialist. The possible problems that a swelling in the neck can indicate are:

Swelling or enlargement of the salivary glands: The salivary glands may become enlarged due to an infection or due to foreign materials getting stuck in them. While foreign objects or formation of stones in the salivary glands might require surgical removal, they can often be dissolved with medication and other non-invasive treatments. And infection in the salivary glands is often treated with antibiotics or other medication. These treatments can be prescribed and administered by ENT Specialists.
Thyroid disease: The thyroid gland may swell up and cause a swelling of the neck. These are often called goiters in colloquial language and are a result of thyroid diseases such as hypothyroidism and hyperthyroidism. They usually require a series of medication and treatment and are not considered an ENT problem despite the swelling of the neck.
Benign cysts: Benign cysts can form in any part of the neck or in the glands, much like it can form in any part of the body. An ENT Specialist can prescribe a surgical removal of the cyst lest it turns cancerous later in life. It should also be removed in case it grows or relocates, going on to cause other problems.
Lumps in the muscles: Lumps in the neck muscles are formed by injury or torticollis. These usually aren t considered ENT problems and can be treated by general physicians and sometimes chiropractors.
Cancerous cysts or growths: One of the most daunting problems posed by a swelling of the neck is the possibility of cancer. While thyroid cancers as well as cancerous growths in the salivary glands are slow to develop, a swelling in the neck should immediately be investigated by an ENT Specialist in order to rule out all possibilities.

Neck Swelling - When It's An ENT Disease!!

With the change of season, we all have to be geared up for the increase in the number of mosquitoes in and around our homes, and among these is one such mosquito, which can be fatal for your life. The bite of the  Aedes aegypti  mosquito causes Dengue. This mosquito survives and breeds in tropical and sub-tropical areas. It is a waterborne disease and causes extreme pain, discomfort and in some cases even death. Each year 390 million people are inflicted with dengue out of which 96 million develop serious illnesses and are required to be hospitalized.

Causes:
1. As mentioned above it is caused by the bite of the  Aedes aegypti  mosquito.
2. When a mosquito bites a person who already has dengue, it becomes infected and it can be transmitted to any healthy person this mosquito bites next.
3. If you already have dengue and are infected again then you have a higher chance of developing dengue hemorrhagic fever or a dengue shock which can even cause death.
4. Living near a stagnant water body, or accumulating water in open containers, staying in the vicinity of clogged drains and open windows can also expose you to the threat of Dengue.

Symptoms:
The symptoms can last to about 10 days after one gets infected. The symptoms are as follows:
1. Excruciating pain behind the eyes
2. Severe headache
3. Sudden high fever.
4. Vomiting
5. Fatigue
6. Skin rash which generally appears two to five days after you get bitten.
7. Nose bleeding, easy bruising and bleeding gums.
8. Severe muscle and joint pain.

These symptoms can be mistaken for high fever or viral infection, so it is important to get tested as soon as you start experiencing these symptoms. If dengue is not treated in time, it can give rise to dengue hemorrhagic fever. In this case, you can suffer from high fever, nose bleeding (damage of blood vessels), failure of the circulatory system and enlargement of liver.

You can also prevent dengue by avoiding storing water in containers, keeping your surroundings clean, wearing full body clothing, using mosquito repellants, sleeping under a mosquito net and setting mosquito traps. Dengue is very devastating and can cause death in worse cases as in dengue shock or dengue hemorrhagic fever. Dengue is now an epidemic in many countries. People affected with dengue need to drink a lot of fluids and take plenty of rest. They can also reduce the fever by having a paracetamol.

Dengue - Signs You Must Be Careful About!

'Congratulations! You're pregnant!' Almost all women long to hear these words and nothing should come in the way, even diabetes. So, if you are a Type 1 or Type 2 diabetic, here are a few things you should keep in mind to have a healthy baby.

1. Your blood sugar must be monitored regularly-
The most important thing you can do to have a healthy baby is to keep your blood sugar as close to normal before and during your pregnancy. Testing is recommended a minimum of four times a day. Glucose passes through the mother's blood to the fetus and hence if your blood sugar fluctuates, so will your baby's. High blood sugar levels are especially harmful during the first 8 weeks of pregnancy when the baby's brain, heart, kidneys and lungs are formed.

2. Your pregnancy is considered high risk-
High blood sugar levels can increase the risk of a miscarriage as well as the risks of your baby being born with birth defects. Diabetes can also increase the risk of developing preeclampsia during the second half of your pregnancy. This could result in a C section or premature birth. Thus, maintain regular checkups and keep your doctor in the loop of all your activities.

3. You should watch out for signs of ketosis-
When you have low blood sugar, the body produces ketones that can be passed on from you to your baby. This production of ketones is a result of the body's burning of fat instead of glucose to provide energy and can develop a condition called ketosis. Symptoms you should watch out for are stomach aches, nausea, fatigue, muscle stiffness, frequent urination and fruity breath.

4. You need Vitamins and Supplements-
Most women require vitamin and mineral supplements at the time of pregnancy. Of these, folic acid, iron, calcium and vitamin D are the most important. These supplements help in the healthy growth of the baby.

5. You should exercise regularly-
Maintaining a regular physical activity routine is very important for diabetics who are expecting a baby. This will help you regularize your blood sugar, relieve stress and strengthen your heart. Avoid activities that increase your risk of falling and aim for at least thirty minutes of daily exercise such as walking, swimming or yoga.

6. Check your medication-
Some medication can be detrimental during pregnancy such as cholesterol and blood pressure medication. Consult your doctor to find a suitable alternative if needed. You may also need to change the kind of insulin you take and its frequency and amount. As you get closer to the delivery date, your insulin requirement may even double or triple.

The key to preventing complications during pregnancy is controlling your diabetes. So take your insulin regularly, maintain regular checkups and eat healthy. You need to be seen by your obstetrician more frequently. Your pregnancy will be monitored closely by more frequent ultrasounds and NST. If your sugar level remains under control and pregnancy is advancing well, a natural onset of pains is aimed for and normal delivery is expected.

Diabetes - How To Handle It While Pregnancy?

Do you need vitamin supplements? Here's how to find out

Taking vitamin and mineral supplements is increasingly becoming common these days. People generally opt for these supplements to ensure good health as their diets are usually lacking in vitamins due to the pursuit of a hectic lifestyle.

But before you begin consuming vitamin supplements, it's necessary for you to know whether your body actually needs them. According to nutritionists, you should plan your diet appropriately to fulfil your nutritional needs and not depend on vitamin supplements to do so. If your diet includes foods like fruits, green vegetables, whole grains, low-fat dairy products, legumes, fish and lean meat, you won't need vitamin supplements.

So, when exactly do you need vitamin supplements?

You might need vitamin supplements in the following cases:

- If you are above the age of 50, you can take vitamin b-12 supplement. Additionally, you may consider eating food items fortified with vitamin b-12, like fortified cereals.

- If your diet does not meet the normal requirement of 1, 600 calories a day, you should consider dietary supplements. Moreover, the diet of people who do not consume red meat usually lacks in zinc and iron, which can be supported by vitamin supplements.

- If you are a woman whose menstrual cycle is associated with heavy bleeding, you might need vitamin supplements.

- If you suffer from a disorder that has a negative impact on the nutrient absorption process of your body, you need to take vitamin supplements. These conditions include chronic diarrhoea, food intolerance, food allergies or any disease related to the liver, pancreas, intestines and gall bladder.

- If your body has difficulty in absorbing and digesting nutrients because of a surgery of the digestive tract.

- If you are a woman who is planning to have a child. Women who want to get pregnant should consume 400 mg folic acid, which can be obtained from dietary supplements or fortified foods.

- If you are pregnant, you should include a prenatal vitamin in your daily diet. This vitamin should contain iron. You may also fulfil this iron requirement by consuming a separate iron supplement.

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

Do You Need Vitamin Supplements?

Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

Hives, or  Urticaria  in medical parlance, is a skin condition characterized by the appearance of itchy swellings on the skin surface. Hives may break out on any part of your body and can be of different sizes. It is not a prolonged condition and generally lasts for a few hours. Urticaria or hives usually occur due to the secretion of certain chemical substances such as  histamine  from underneath the skin surface.

Some of the possible causes of hives are mentioned below:

Overexposure to sunlight
As a side effect of medicines such as aspirin, painkillers or antibiotics.
Insect bites
Any food related allergy may also trigger hives
People allergic to certain chemicals or latex can also develop hives
Sensitivity to temperature or water can cause hives
Infections such as Hepatitis or chronic diseases such as thyroid may result in the occurrence of hives.
Alcohol or caffeine intake can cause chronic urticaria
The most common symptoms of Hives include:

Skin becomes swollen
Frequent itching sensation
Skin inflammation is also common
You may feel a burning sensation
Within a short span of time, it may disappear and then again reappear on different parts of the body
Red and white patches appear all over the skin surface known as  wheals 
Hives generally go untreated as the condition subsides within a few hours. But sometimes, hives can be chronic or acute in nature. If so, it would require treatment as it can give rise to further complications. Some of the treatment methods are given below:

Corticosteroids may be prescribed by the doctor to control the formation of hives and give relief from inflammation.
Antihistamines (drugs which hinder the impacts of histamines; mainly used for curing allergies) are advised to patients with chronic urticaria. It controls the effects caused due to the discharge of histamines.
Knowing and avoiding the trigger conditions may prove to be helpful.
Applying menthol creams can give comfort due to its cooling properties.

Hives - Causes, Symptoms & Treatments

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