Anger is among the gamut of emotions we exhibit as a reaction to a situation, and it is a'normal' emotion too as long as it is kept under control. Some people have the propensity to explode when pushed to the extreme. They keep swallowing their emotions until they can finally do it no more, and erupt like a volcano. Others dealing with extreme anger are like a ticking time bomb. You'll never know what you unwittingly say or do can trigger an explosion. In either case, anger that cannot be controlled comes with a physical reaction.

Your heart beats faster preparing you for both action and reaction. Your breathing quickens. You may clench your fist, tighten your shoulders and go into a defensive position. The problem arises out of the fact that it is almost impossible to feel anger and empathy at the same time. An angry person is seldom sensitive to the well being of his victim, and hence may lash out verbally and sometimes physically. Such things done in the heat of the moment mostly leaves us with regrets. So here are a few ways to deal with extreme anger.


	Acknowledge it: the first step in solving a problem is recognizing that you have one. The fundamental problem here is that people believe they are on the right track and refuse to budge from their views. It is essential to realize that this step is not about deciding whether you are right or wrong, but acknowledging the fact that your reaction to the situation can be channeled in a better way. When getting someone to acknowledge their anger problem, be careful as to not use negative words like wrong, false and shouldn't. Instead, influence with positive words like can and should. Instead of saying'you are wrong to react like this, you can say'i understand what you are feeling. Is there a way we can resolve this situation'
	Recognize the signs: once you know that your problems exist, you can try devising ways that will work for you in dealing with the situation. You can count to 10 to calm yourself or simply decide to not speak until you can calm yourself. Knowing that you may enter into an argument in a situation, you can list down the points that you feel strongly about and discuss each of them one by one. Working your way through a finite list gives a better opportunity to reach closure at the end.
	Find ways to let it go: not all arguments end in closure. A lot of unsaid justifications cloud our mind repeatedly leaving us seething from the inside. Research has shown that the neurological anger response lasts less than two seconds. Beyond that it takes a strong will to stay angry. Once you realize how much your anger is consuming your mind, decide to free your mind with meditation and other calming exercises. Tell yourself that some people and issues simply don't deserve your anger, emotion, reaction or time.


If you or someone you know is suffering from anger management issues, consult a doctor today.


How To Control Extreme Anger

In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

Are you aware of the number of people who suffer because of pneumonia? As the weather becomes cold and damp, chances of getting affected by pneumonia increases. Pneumonia can originate from virus, bacteria and a host of other factors. It is one of the most common ailment which affects the adults, all over the world. Hence, it is important for all of us to prevent  ourselves from pneumonia and for that we can follow the below mentioned steps:

Know about the symptoms of pneumonia first: It is difficult to detect or diagnose pneumonia, especially in people over the age of 65. In older patients, the common symptoms such as fever, chills, cough may not be experienced. You should watch out for non-respiratory symptoms like weakness, dizziness, delirium and confusion. It is even more difficult to diagnose pneumonia in people who are suffering from preexisting conditions.
Practice good hygiene: Common respiratory infections, influenza and cold may cause pneumonia. You should follow hygienic habits. Wash your hands regularly before meals and use hand sanitizers in order to prevent the illness from spreading. You should also maintain proper oral hygiene as several oral infections may also lead to pneumonia. You should also keep away from people who are affected by pneumonia or any other illness like flu, cold and serious diseases such as measles or chicken pox. All these factors may cause pneumonia.
Get vaccinated: It is recommended for people of all ages who may be at a risk of getting pneumonia to get vaccinated and immunised against pneumonia causing virus called pneumococcal pneumonia. This is a one-time vaccine, which prevents and reduces the severity of pneumonia. A booster vaccine after every five years may also be prescribed. Elderly people should be vaccinated against all diseases which cause pneumonia.
Quit smoking: Smoking accounts for being a major cause or risk factor for pneumonia. It increases a person s chance of getting pneumonia as the lungs  ability to defend themselves from the infection is reduced. By quitting smoking, you will be able to prevent pneumonia.
Maintain a good general health: Maintaining an overall good health and following healthy habits will help you in preventing pneumonia. This is because your immune system stays strong and is able to fight efficiently against pneumonia-causing infections. A proper diet with all essential nutrients is also recommended along with regular physical exercise and proper rest.
Severe cases of pneumonia are capable of making you suffer and you may be admitted to a hospital. According to studies, it has been estimated that more than 60% of people over the age of 65 need to be hospitalised because of pneumonia.

If you wish to discuss about any specific problem, you can consult a pulmonologist.

Pneumonia - 5 Ways You Can Prevent Yourself Against it

The kidneys may be a pair of small organs but they perform a very important function. Without the kidneys, it is impossible to filter blood and remove toxins from the body. One of the common problems associated with kidneys is the development of a kidney stone. This can be described as a hard, pebble like substance that is formed when urine contains high levels of certain minerals. Kidney stones vary in size and shape. Small stones may pass through the ureter into the bladder and out of the body with minimal discomfort. However, in some cases, a kidney stone can be as large as a golf ball. In such cases, it can block the urine flow and cause extreme amounts of pain as well as bleeding. In such cases, a doctor needs to be consulted as early as possible.

There are four different types of kidney stones.

Calcium Stones: This is the most common type of kidney stones. It is caused by excess calcium that is not flushed out with the urine.
Uric acid stones: Highly acidic urine can trigger the development of such stones. This may be caused by excessive consumption of meat, fish and shell fish.
Struvite stones: This is often formed as a side effect of Urinary tract infections. These stones may develop and grow rapidly.
Cystine stones: These stones are formed as a result of a genetic disorder known as cystinuria. This disorder causes an amino acid known as cysteine to leak into the urine.
Kidney stones are a fairly common occurrence. It affects both men and women but men have a higher risk of developing kidney stones as compared to women. Other risk factors that can influence kidney stones are:

Family history of kidney stones
Not drinking enough water
Obesity
Digestive problems
Recurrent UTIs
Gout
Bowel inflammation
Disease that causes blockage of the urinary tract
Certain medications such as diuretics or calcium based antacids
Once a person has been diagnosed with a kidney stone, this issue can recur. Treatment for kidney stones depends on the type of stones, size and location. In most cases, medication is prescribed to help break the stone down into smaller parts so that it can pass through urine. In extreme cases, surgery may be required. If not treated in time, it can cause severe pain, bloody urine, UTIs that can further lead to kidney failure and reduced kidney functioning.
Kidney stones can be prevented by drinking plenty of fluids and making a few dietary changes. Ideally, a person should have a minimum of 8-10 glasses of water a day. If you have a high risk of developing any type of kidney stones, reduce your sodium consumption and the amount of meat eaten.


Kidney Stones - Are They Really Common?

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