Intercourse is meant to be a pleasurable and intimate experience. But it might become an unpleasant act if you are suffering from performance anxiety. When you are mentally occupied by questions such as "Do I look too fat?" or "Did I do that right?", sex stops being a gratifying experience.

Incessant anxiety over your ability or appearance can result in sex becoming nerve-wracking and stressful for you. It might even have you avoiding sex altogether. This psychological condition is termed as sexual performance anxiety.

Sex isn't only a physical reaction, there are emotions tied to it as well. If you are too stressed out and your mind is preoccupied, your body reflects your inner turmoil and you cannot get aroused.

Causes
The causes of sexual performance anxiety include:
1. Fear that you wouldn't be able to satisfy your partner and perform well sexually
2. Body image issues (Such as stressing about your weight)
3. Problems in your relationship
4. Men worry that their penis don't 'measure' up
5. Men might be concerned about taking too much time to orgasm, or about premature ejaculation
6. Women worry about not enjoying the experience or being unable to have an orgasm

Symptoms
Your mental state has a deep impact on your physical state. The effect of stress hormones norepinephrine and epinephrine can hinder your sexual performance. Symptoms of sexual performance anxiety include:

1. In men, blood vessels constrict due to the effect of stress hormones. This leads to reduced blood flow to the penis, thus making it difficult for the man to get an erection.

2. Often though it is less diagnosed in women, sexual performance anxiety leads to trouble in lubrication during sex. Lack of lubrication dims the desire to have sex.

Sexual performance anxiety is a vicious, inescapable cycle. Increased anxiety hampers you from having sex, making you think you won't be able to perform well, which causes even more anxiety.

Treatment
Consult a doctor you will be comfortable with discussing your problems. Sexual performance can be either treated by medication (if you have an underlying medical condition such as erectile dysfunction) or through therapy.

Talking to a therapist or counsellor about your problems can help you in several ways. You can learn to become more comfortable with yourself and your body. You can also understand your problems better, which can eliminate your anxiety.

All About Sexual Performance Anxiety

While some scars are negligible, others can mar your beauty. With cosmetic surgery, today, it is easy to remove scars and make them less prominent. Scar revision surgery can range from invasive procedures, such as scar excision to non invasive procedures like cryotherapy, laser therapy and topical silicone therapy. However, none of these have perfect results. The main aim of scar revision surgery is to make the scars blend in as much as possible with the surrounding skin in terms of colour, texture and elevation.

Picking a scar revision procedure is a matter of weighing the pros and cons of each type of procedure and the cause for dissatisfaction: 
1. Functional limitations of the scar and likelihood of functional impairment after surgery
2. Patient's expectations
3. Location of the scar
4. Quality of skin type and surrounding tissue

Scars are formed due to a number of reasons, such as acne, cuts, burns, surgery and infection in a wound. Scars created by an overproduction of collagen are the most difficult to treat. In most cases, a patient requires multiple surgeries for scar revision.

Some of these surgeries are:
1. Surgical Excision: This procedure is usually performed on large scars that do not respond to medication. Here the surgeon shaves and cuts down scar tissue to minimize the size of the scar.
2. Laser Surgery: This is used to smoothen the scars with raised or uneven surfaces. It involves the removal of the top layer of skin and tightening of the layer below it.
3. Z plasty and W plasty: These surgical treatments aim to reduce the visibility of the scar by repositioning them along the natural lines and creases of the skin. All topics that sent after editing should be considered as approved.

All About Scar Revision Surgery

The immune systems in your body are always at work trying to fend of many of the attacks that happen on it every day. Although it is able to protect the body most of the time, sometimes it fails in doing so. While medicines can help to restore the balance, it is advisable to include certain food items in your diet, which boost the immune system naturally. Let's take a look at six vegetables which can help your immune system in getting supercharged:

Ginger - This food item is very good in regulating mobility within the gut and regulating bowel movement and is also known to relieve nausea, cramping and bloating. Ginger is also known to have many anti-inflammatory properties as well as being an antioxidant and antimicrobial. All of this makes ginger very good for the immune system.

Wheatgrass - One of the most densely packed green nutritional food ingredients when consumed in the form of a juice, it helps the liver by increasing its ability to flush out toxins. This results in an improved immune system. Wheatgrass is also rich in B complex vitamins, beta carotene, chlorophyll, magnesium, potassium and many other vital nutrients.

Garlic - This vegetable has been used for centuries in home remedies such as to lower blood pressure, prevent blood clots and many others. Garlic is also known to boost healthy cholesterol. Inclusion of garlic in your diet will not only boost your immune system but it also contains 'allicin', which is known to improve the health of your heart.

Papaya - An extremely good food for digestion as well as digestion problems, the extracted enzyme from this plant known as papain, is used in many medications. Papaya is full of beta-carotene that is very well known to be good for the health of tissue, skin and the eyes as well as boosting the immune system through the production of vitamin A within the body.

Carrots - This is one vegetable which has been encouraged to be included in diets as it contains copious amounts of beta carotene and is extremely good for the eyes as well as boosting the immune system.

Turmeric - Possibly the most talked about ingredient on this list in the last few years, it is known to have almost an unending list of health benefits. Turmeric has detoxifying properties as well as being anti-bacterial, anti-inflammatory and is great for digestion along with boosting the immune system.It is a rich source of minerals, such as Zinc, Iron, B group vitamins and Manganese, turmeric is also known to have cancer preventive properties.

Top 6 Vegetables that Supercharge your Immune System

Jaundice is a medical condition where the bilirubin level shoots up in the blood of the affected person. Also referred to as icterus, the condition may affect adults as well as newborn babies (Neonatal Jaundice), whereby the skin and the white part of the eye (sclera) appears yellowish in color (due to the accumulation of bilirubin).

Bilirubin is the bile pigment that results from the breakdown of hemoglobin (when the RBC cells breakdown). The bilirubin thus produced is released into the plasma. The liver then filters the released bilirubin for further metabolism. In the case of a diseased condition, injury or infection to the liver, it fails to remove the bilirubin from the bloodstream. As a result, there is an abnormal rise in the bilirubin level in the blood (Hyperbilirubinemia), resulting in jaundice. In jaundice, Bilirubin can go upto much higher levels. At 2.5-3 it just starts to get manifest as yellow eyes. Obstructive jaundice may require an endoscopic procedure or surgery. 

Types of jaundice:
Jaundice may be of the following types:

Hepatocellular jaundice: In Hepatocellular jaundice, the elevated bilirubin level in the blood is an outcome of a liver disease or an injury (altering the normal functioning of the liver).
Hemolytic jaundice: Here, the increased level of bilirubin in the blood results from an increased breakdown of the RBCs (Hemolysis).
Obstructive jaundice: As the name suggests, Obstructive jaundice results from an obstruction in the bile duct. As a result, the bilirubin does not get filtered and remains in the liver.

Factors contributing to jaundice:
The increased buildup of bilirubin may be an outcome of

Obstruction and inflammation of the bile duct.
Chronic liver disease including liver cirrhosis and hepatitis.
Pancreatic Cancer.
Hemolytic anemia: It is a condition resulting from increased breakdown of RBCs.
Gilbert's syndrome.
Certain medications may also interfere and alter the normal functioning of the liver (steroids, birth control pills, and acetaminophen, to name a few).
In cholestasis, the bile (conjugated bilirubin), instead of getting eliminated, remains in the liver.
Symptoms:
The symptoms associated with jaundice include

The skin (particularly, the face, hands, nails, and feet) and the sclera appear yellowish.
The urine appears dark in color.
Fever, vomiting, tiredness, and loss of body weight.
Abdominal pain (mild to severe).
The stool appears pale in color.
Itchiness or Pruritus.
Diagnosis and treatment:
The earlier the diagnosis, more effective is the treatment.

Jaundice can be diagnosed by
Physical examination.
Bilirubin tests to determine the total bilirubin level.
CBC is used to determine the levels of RBCs, WBCs, and platelets.
Liver function tests.
The treatment for jaundice involves identifying the underlying factor responsible for the condition and treating it.

In the case of obstructive jaundice, operation helps to improve the condition.
Patients with hepatitis may benefit from antiviral medicines as well as steroids.
In hemolytic anemia, use of iron supplements helps to improve the condition.
Avoid oily and spicy foods, smoking and drinking.
Rest as much as possible.

Jaundice - The Right Way It Can Be Treated!

Change in voice or voice mutilation happens when the voice breaks that commonly occur when a person reaches puberty. Before puberty, almost all the girls and boys have the same voice pitch. But after puberty, a boy s voice deepens an octave and the girl s voice deepens only several tones. Therefore, it becomes easy to identify the gender through voice. 

Another type of change in voice is known as voice crack. It happens when a person unintentionally enters a higher voice pitch zone for a brief period of time. It may be due to singing, shouting, talking in noise, and several other reasons. Also, there are several medical conditions leading to voice break or hoarseness. 

Medical Causes for Change in Voice

Acute Laryngitis: In this, the hoarseness or voice loss starts suddenly. One of the reasons can be a viral infection that causes swelling of vocal cords. Staying hydrated and less talk can treat it. 

Chronic Laryngitis: It can cause acid reflux disease. Exposure to irritating smoke, infections of vocal cords, or asthma can be some of the reasons. It can be cured only through medication.

Laryngopharyngeal Reflux Disease: This problem causes a change in voice. Due to this disease, people may also suffer from swelling issues, a lump in the throat, hoarseness in voice, and throat pain. 

Voice Misuse: Excessively loud voice, prolonged talking, and inefficient voice use can cause a change in voice and also known as voice misuse. 

Risk Factors That Can Cause Voice Disorder

Aging, alcohol use, and allergies are some of the major reasons for the voice disorder. Apart from these, smoking and throat cancer also results in a change in voice or voice disorders. All these are highly risky causes for the throat and may result in long-time problems. 

Some other risk factors are thyroid, psychological stress, and neurological disorder. 

How to Treat Voice Disorder?

One can use an air humidifier to keep the air of the surrounding moist because breathing moist air is a simple solution to the problem.

Giving rest to voice is also a solution.

One must drink plenty of liquids to keep the throat hydrated.

One must avoid whispering and decongestants to take care of the throat.

One must avoid shouting for a long time.

Avoid staying in a polluted area for a long time.

Gargling the throat every day with lukewarm water is good.

Staying warm during winters is also necessary.

All these remedies are simple and can be tried comfortably. A simple change in voice can turn out to be serious if not taken proactive measures. Therefore, one must not ignore any small unintentional change in the voice.

Conclusion
One must consult ENT doctor immediately for any sudden change in voice and if the problem lasts for a long period of time. 



Change In Voice - What Can Cause It?

How To Take Care Of Nail Health 

Nails significantly reveal about your overall health.When well taken care of, nails not only look good but they also help you stay healthy.
Follow these tips for a shining nails.
1. Moisturize - Use a Hand-Nail cream regularly to avoid ragged cuticles and flakey skin. Moisture keeps your nails in a good shape.

2. Mild Soaps - Use specially formulated hand foams to wash your hands. Certain anti-bacterial soaps can strip away layers of essential oils from your skin, thus leaving your palms dry and even itchy.

3. Massage - Massage your cuticles regularly. This will help improve blood circulation to the tips as well as stimulate the entire nervous system promoting the growth of strong and healthy nails.

4. Manicure - Treating your hands once a month to a relaxing manicure is an excellent idea. Not only do your nails end up looking fabulous but the additional TLC will go a long way in ensuring that your hands don’t look twice their age. Scrubbing off the dead cells, applying a ‘hand mask’ and then some relaxing massage as you close your eyes to some soothing music, is just what ‘nail therapy’ is all about.

5. Maintain - It’s a common knowledge that the skin on our hands tends to age quicker as it is often left exposed to the elements such as the harsh sun or extreme winters. To maintain your manicured nails, use a sunscreen regularly and wear gloves in the winters and even while going about household chores such as doing the dishes or mopping the floor.

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

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