PCOS (Polycystic Ovary Syndrome) is a common disease of the endocrine system among women who have attained the reproductive age. Women with this condition generally have ovaries larger in size than the usual, containing small pockets of fluids, also termed follicles. These 'follicles' develop in each of the ovaries as diagnosed with the help of an ultrasound exam. Abnormal or extended menstrual cycles, unusual growth of hair and obesity are some of the common accompanying conditions associated with PCOS. This disorder can interfere with a woman's menstrual cycles, thus making pregnancy difficult. More so, this condition can also impact the way you look and if left untreated for long, can lead to underlying disorders such as diabetes and other cardio vascular diseases.

Causes of PCOS
1. Excessive Insulin secretion: Insulin is a hormone secreted by the pancreas, which allows the body cells to utilize the sugar; the most important energy store of your body. If you suffer from insulin resistance, your body's ability to utilize the insulin gets affected adversely. This forces the pancreas to secrete more insulin in order to keep up with the body's energy supply. This excess insulin might result in an increase in the production of androgen, which in turn, might interfere with the ovulation ability of the ovaries.
2. Low- level inflammation: Inflammation is the process by which your body's white blood cells fight infections. Studies reveal that women suffering from PCOS have a low level inflammation which acts as a catalyst in the production of androgens.
3. Can be hereditary: If you have someone in your family suffering from this syndrome, you might automatically be at a higher risk of developing this disorder.

Symptoms accompanying PCOS
1. Abnormal menstrual is the most commonly observed symptom. Women suffering from PCOS may have less than nine periods in an entire year and in some cases, even none. 
2. Excess secretion of male hormone, which is related to excess androgen production may result in symptoms, such as abnormal body and facial hair, acne and baldness, which is identical to that in men.
3. Unexplained increase in weight and difficulty losing it as well.
4. Another fairly noticeable symptom is depression.
5. Infertility

PCOS- Causes and Symptoms

For a child, the first visit to the dentist can be panicky. This is because they don't realize what's in store. Children get a better idea about dentists after getting some information about the visit. We, as grown ups, must be set up to answer the inquiries and instruct our children in the most ideal way. The following are some valuable tips on the best way to set up a child for the first dentist appointment.

1. Guardians regularly ask when they ought to take their child for the first ever dental visit. The best time to begin taking children for a dental checkup is either when their first tooth pops out, or right around their first birthday. Expert dentists are capable of instantly recognizing any potential issues with the development and advancement of the jaw and delicate palate. Children's teeth are more porous and defenseless to decay than grown-up's teeth; so early mediation is a basic to guarantee those small teeth staying sound. It is also recommended that guardians begin brushing their child's teeth when they start coming out, utilizing a delicate toothbrush and plain water. Brushing should be started as early as possible.

2. It's never too early to begin acquainting your kids with tooth brushing and knowledge of oral health. The best time to begin is before your kid's first dental visit. Youngsters love to find out about their bodies, and love to grin, touch, and investigate new things. There are many fun ways to impart oral health education to children. The more agreeable they are with their mouth and teeth, the less demanding your youngster's first dental visit will be.

3. Tooth brushing is an essential piece of our everyday self-care, and it is our habit. A child, after being introduced to a brush and a toothbrush will take a certain time period to make daily brushing a habit. Guardians and the kids can brush their teeth" together. It is essential to note that toothbrushes are apparatuses, not toys, and that infants and babies ought to be firmly directed.

4. Little children, are extremely insightful and touchy to the states of mind of people around them. Children regularly reflect our conduct. When we are casual and upbeat, children will probably be loose, as well. Children are additionally more casual when they are prepared for or taught something. Invest energy conversing with children about going to the dentist. You can also discuss what the dentist will do, emphatically.

5. Always choose the most trustworthy dentist who is friendly and knows how to handle a child on his first dentist visit.

A child's first dentist appointment is a special one, and you should prepare him accordingly.

Tips to Prepare Your Child For First Dental Visit

A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.
Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.


Time Duration of a Therapy Session:
While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.


Physiotherapy in a Hospital:
If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.


Physiotherapy at Home:
Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.


In the Clinic:
Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. 




How Long Do You Need Physiotherapy Post-Fractures?

Anal Fissure is a small tear in the anal area. This can happen due to injury while passing hard formed stool or even by repeated bowel motion. It may be very painful especially at the time of passing hard stool. 

Symptoms

Most commonly sought symptoms in Anal Fissure are as given below: 

  A noticeable tear in the skin close to the anus. 

  Cutting or burning pain in anal passage while passing stool which may persist for a considerable time

  Sometimes pain is so severe that patient stops eating in an attempt to avoid defecation to avoid pain

  Blood stains on stools may also be there

  If not treated in time; skin starts growing from the lower end of fissure to form a tag known as sentinel tag/sentinel piles.

  At times; sentinel tag may get inflamed.

Causes

  Passage of hard stool through anus. 

  Chronic Diarrhoea

  Trauma to the anus and anal canal like during childbirth

  Inflammation in anus because of crohn's disease or some other inflammatory disease 

Anal Fissure treatment: Diet: High fiber diet like green leafy vegetables, salads, fruits like papaya, chikku are advised. Resins with milk can also be taken in night. Adequate quantity of liquids especially butter milk is advised. Banana, apple etc. should be avoided. 

Graded Kshar Karma & Ksharsutra: Anal Fissure can be completely treated by Graded Kshar Karma and Ksharsutra treatment. In acute anal fissure; stool softener along with Graded Kshar Karma is advised. In this treatment; Graded Kshar - a specialized Ayurvedic medicine is applied in fissure region. This medicine debrides the fissure and induces healing. Usually pain subsides in a week or 10 days time period when fissure is still in healing phase.

Considering pain has subsided; some patients discontinue the treatment to further aggravate and complicate the problem. For complete healing of anal fissure usually 3-5 Graded Kshar Karma sittings are required at a weekly interval. In between these weekly sittings patients are advised to apply certain medicines in anal passage by themselves. If anal fissure has progressed to development of sentinel tag then Graded Ksharsutra TM treatment is the treatment of choice. 

In this treatment Graded Ksharsutra TM is ligated at the root of sentinel tag. Medicine released from Ksharsutra blocks the blood supply of sentinel tag and it sheds off in a week or 10 days time period. No hospitalization or bed rest is required in this treatment. Patient can continue his normal routine activities as usual during his treatment. So, you can say no to surgery in Anal fissure.

Anal Fissure - Say No To Surgery!

Knowing premature ejaculation - part 3: management and techniques (non-medical methods)

As shared in part 1and 2 of this series, because of premature ejaculation (pe), both the partners may end up experiencing highly unsatisfactory sex. In fact, it can increase anxiety, which may deteriorate the problem. 
Remember there is not a single magical drug or medicine in the chemist shop which can solve your problem overnight especially if you have chronic pe. Before seeking any medical treatment for pe, it is appropriate to consider the varied options for solving this issue. These include counseling with a sexual therapist, non- medical treatments like various exercises/ techniques and medical treatments including both modern and alternative medicine.

A. Counseling from an expert - sexual therapist or sexual medicine practitioner:
It is well understood that sex is in the mind. However, repeated pe/ failures can lead to lot of stress and disappointments. Anxiety due to pe itself is a big issue and can lead to recurrence of pe.
Reassurance from sexual therapist / counselor that pe is not a disease and can be easily treatable is relaxing for men who are facing this problem. So please share your detailed history and sexual habits with the expert. This may help the expert to guide you well.

B. Behavioral changes:

Some basic things may also help you to deal with the problem. 

1. Some men attempt to treat themselves for premature ejaculation by distracting themselves by thinking nonsexual thoughts (such as naming cricket players and records) to avoid getting excited too fast when approaching their partners. This helps them to focus their attention away from the sexual stimulation.

2. It is also suggested to men that they should relieve themselves of the sexual tension by ejaculating with self masturbation 1-2 hours before attempting sexual intercourse with their partner.

3. Using condoms is known to help in premature ejaculation in some men by decreasing sensation.

4. Women on top position usually helps to delay orgasm in men

 
C. Exercises &amp; techniques:

There are several exercise and techniques you can try sitting in your home.

1. The" stop and start" method:
This technique involves sexually stimulating the man by self until he feels like he is about to reach orgasm. Then he needs to stop the stimulation for about 20-30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. This can be continued for 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
2. The" squeeze" method:
 This technique involves sexually stimulating the man by self or by his partner until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans penis meets the shaft) for at least 15 seconds. Stop sexual stimulation for about 60 seconds, and then start it again. The person or couple may repeat this pattern for at least 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
3. Practice breathing exercises 

Deep breathing can greatly help in controlling the arousal and tension that cause early ejaculation. Men must avoid shallow breathing as it can trigger premature ejaculation. Instead, what you should do is spend 5 seconds taking in a long deep breath; then hold it for 3 seconds and then exhale for the next 5 seconds. If you can do this for 5 minutes in the bedroom without pause then you can control premature ejaculation.

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

Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)

Depression is spreading at a fast pace in modern India due to many reasons like poor diet, lifestyles, poor social support system and having too many unrealistic expectations from themselves and other people in their lives. It can affect the rich and the poor and any age group also. According to World Health Organisation, 1 in every 10 people suffer from depression. Due to the social stigma attached to it, most people remain undiagnosed and hence suffer from it silently. This is a huge waste of human potential and capability. Some common symptoms of Depression include:

Appetite loss or an increased hunger,
Insomnia or Oversleeping,
Pervading feelings of worthlessness, helplessness and hopelessness,
Anger and Irritability,
Intense physical, emotional and mental fatigue,
Self hatred for making mistakes and not coming up to the expectations of self or other people
Risky Behaviour like rash driving, addictions, dangerous sports,
Problems in Concentration, Memorising and Focussing
Unexplained aches and pains, stomach-aches, Back pain or Headaches
Sudden loss of Interest in Daily Activities, Hobbies. Work
Suicidal Thoughts or Attempts

Here are some basic tips to beat the blues.

Recognising and Conquering Self Criticising Inner Voice:
You would have heard this harsh voice which often reprimands you for making mistakes, or doing something silly or taking any risks. Often this voice would have said, "Its always your fault"," You are capable of nothing"," You are always making mistakes", "Only bad things have happened in my life", " My life is Over". These are called self destructive negative thoughts which can interfere and distract you from your daily activities and a general sense of confidence, power, wellbeing and balance. Depressed people often associate themselves with a negative image of self and of the world, which is very incapacitating and makes the person feel guilty, angry, worthless, hopeless and helpless. The trick is to combat this inner thinking process with evidence to disprove it and support the evidence with logical and rational reasoning and seeing the whole picture with its positives rather than focussing on the negative parts only. For eg.."Good things have also happened in my marriage"," I can learn from my mistakes and do things differently next time"," I have achieved many things in life so I am capable and intelligent"," Life is not over yet, there is hope because I am still alive". such statements are compassionate and help in restoring lost confidence, faith and hope which is vital to beat depression blues.

Be Active:
During depression, physical energy takes a beating as a person goes through an emotionally low phase. People who don't exercise regularly are more prone to depression as the body and mind lacks in blood circulation and "feel good" neuro chemicals called Endorphins. When you are feeling down in the dumps, exercising, yoga, gym, cycling, aerobics, dance can help in elevating the heart rate and thus increasing the blood circulation and elevating the moods. Cycling to work, using the stairs, walking just a little bit as a  daily small goal can be beneficial as energy levels can be very low in depression. Getting the sun on the back bone which carries many nerves is also important and helps in chemical synthesis in combating depression.

Be Social:
Man is a social animal by evolutionary process. We tend to feel better in harmonious social communities for our social and psychological wellbeing. Identify people who are well meaning and supportive of your condition. Don't withdraw from the society, thought hat may be the easiest and logical thing to do in depression. Meeting people with similar interests as yours, people who value you for who you are and some people who are funny and can make you laugh will be of immense importance for boosting your self esteem and self worth. See if some one can benefit from your care..caring for others is a huge booster of self worth and self esteem. Having a pet and caring for it can be another activity that you can look into. Watching comedy shows, movies, laughing at your own mistakes or other people mistakes can be a wonderful way to look at life more objectively. Don't take yourself and other people too seriously..everyone makes mistakes and nobody is perfect.


By no means is this list complete. Please look around and find more tips that can help in beating the blues. If Depression is caught in its early stages then its completely curable. Please don't self diagnose and take medications. Get it diagnosed with a psychiatrist or a psychologist. Cognitive Behaviour Therapy, Stress management, Marital Counselling, Meditations and relaxation techniques, Spirituality are very powerful in dealing with depression too.

3 ways to combat depression

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