Low levels of testosterone can end up affecting various aspects of a your life. It can affect your libido, your performance in bed along with your motivation and energy. Testosterone replacement therapy can bring the levels back to what they were before and restore his lost confidence, energy and vigour.

Testosterone is a hormone which is mainly produced in the testicles. Testosterone controls bone density, distribution of fat, muscle mass and strength, body and facial hair, red blood cell production, sex drive and production of sperms.

Testosterone levels generally lower with age, especially after 30. Usually, in older men, low levels of testosterone result in androgen deficiency. Androgen deficiency affects the muscle mass, bone density, weight and can drastically change sleep patterns as well. On the other hand, testicle injury, testicular cancer or treatment for it, hormonal disorders, infections, HIV/AIDS, chronic kidney or liver disease, type 2 diabetes and obesity can lead to low testosterone levels as well.

While testosterone replacement therapy (TRT) seems very desirable, there are certain risks and benefits which need to be considered.

Factors to be considered before opting for it

1. Sleep apnea is one of the risk factors of TRT. In this condition, breathing stops and starts repeatedly when you sleep.

2. Acne problems and other skin disorders

3. Swollen breasts. Men with breast cancer should not opt for this treatment.

4. TRT can trigger noncancerous prostate growth.

5. Sperm production is limited or the testicles might shrink

6. Chances of deep vein thrombosis (blood clots in veins) leading to pulmonary embolism (clots burst and lodge into your lungs) are increased.

Benefits of getting a testosterone therapy done

1. Sexual drive, performance and function are improved.

2. Mineral density of the bones gets restored

3. Healthy weight loss, thus improving your body composition

4. Muscle strength and mass improves

5. Mood and energy gets a boost

6. Cognitive functions improve

7. Lessens the risks of type 2 diabetes and cardiovascular diseases

8. Improves metabolism

9. Reduces chances of anaemia or improves the condition if you are already suffering from it

Risks and Benefits of Testosterone Therapy

Cyclic vomiting syndrome (cvs) is characterized by periodic bouts of nausea and vomiting that happens at cyclical intervals. It affects all ages, but is more common in children. The condition is quite stereotypical in that there are paroxysms or bouts of vomiting that is recurrent and follows days of normal health.

Causes: there is no definite reason identified, but it is said to have a strong hereditary correlation. Studies have shown mitochondrial heteroplasmic (abnormal growth of mitochondria, which is a cellular component) to be one of the factors that can lead to cvs. The genetic correlation, however, is very difficult to establish, specifically because vomiting and nausea are common symptoms that occur with most conditions in children. And cvs is most commonly noted with conditions like infections and emotional excitement. Infection could be either tooth decay or sinusitis or anything else. Lack of sleep, anxiety, holidays, allergies, overeating, certain foods, menstruation - a host of factors have been shown to induce cvs. There is also a strong association with migraine and conditions that lead to excessive production of stress hormones.

Symptoms: the syndrome (a group of symptoms) usually has 4 phases:

1. Symptom-free interval phase: the child is completely normal in this phase, which happens in between bouts.

2. Prodromal phase: prodrome is an indication that a disease or a condition is about to happen. In cvs, this is usually nausea and abdominal pain that can last from a few minutes to a few hours. Treatment in this phase can curb the disease. However, there could be some children in whom this may not manifest and the child may directly start with vomiting.

3. Vomiting phase: repeated bouts of paroxysmal vomiting happen associated with nausea, exertion, fatigue, and drowsiness.

4. Recovery phase: as the nausea and vomiting begin to subside, which may take a couple of days, the child returns back to normal slowly. However, the lethargy and energy levels will take a couple of days to return to normal.

Treatment: treatment again depends on the severity and the phase at which it is being recognized. If a child has repetitive bouts, then the parent and the doctor would have identified a pattern to it.

1. If the causative agent has been identified, for instance, infection or migraine, then managing that takes care of the cvs also.

2. If identified during the prodromal phase, again it can be managed with suitable anti-emetic medications.

3. If identified after full onset, rest and sleep and medications to control nausea and vomiting are required. Adequate hydration with electrolyte replenishment and sedatives can provide additional support.
However, in most cases of childhood csv, the pattern will be identified and that helps in better management, both the child/parent and the podiatrist.

Cyclic Vomiting Syndrome in Children - Causes, Symptoms, Treatment

Tuberculosis or TB as it is commonly known in medical circles is a bacterial infection commonly affecting the lungs. While there are some countries in the world, where TB is more common, anybody can develop TB if they are not very healthy. The TB bacteria spreads through the air. While some people's immune system would be able to fight the disease back; some people who have risk factors, the disease may continue to develop and present with symptoms. 

So, a person can develop TB in two circumstances:

Exposure to TB
Visited a country where TB is very common
Spent time with a person who is infected with TB
Exposure to crowded places like a market or a healthcare facility where TB virus is present
Weakened immune system
Be HIV infected
Weak immune system due to long-term use of steroids
Chronic diseases like diabetes, malnutrition, end-stage kidney or liver disease, cancer, etc.
Extremes of age (children whose immune system is not fully developed, elderly whose immunity is weakened)
Chronic smoker, IV drug abuse, and/or alcohol user
Repeatedly exposed to TB bacteria in the last two years
Had TB bacteria, but not identified or treated
Drug therapy like chemotherapy, long-term use of steroids, auto-immune disease treatments, etc.
Signs and symptoms of TB: 

If you are at risk, it is also suggested that you know the early warning signs and symptoms of TB. TB most commonly affects the lungs and is known as pulmonary tuberculosis. Watching out for these helps in early diagnosis which can both help arrest the condition in the early stages and improve prognosis.

A persistent cough which lasts for more than 3 weeks
Pain in the chest worsened with coughing
Presence of blood in the sputum
Generalized and extreme weakness or fatigue
Unexplained weight loss
Loss of appetite
Fever and chills
Profuse sweating at night
If a person has TB bacteria in the system but does not feel sick and does not have the above systems, then it means that the person is not actively infected. This person also cannot spread the disease to another person. However, when immunity is weak, this can develop into an infection. In a country like India where tuberculosis is quite prevalent, it is best to get yourself screened for active tuberculosis infection if you display any such symptoms.

Tuberculosis (TB) - When A Person Can Develop It?

6 Causes of hair loss you didn t know about and how you can combat this problem

In order to have healthy volume of hair on your head, the rate of hair loss and replacement should be in tandem. With age, your hair growth cycle shows signs of slowing down and factors like age, disease, and hormonal changes among others affect the pace at which an individual hair follicle moves through the 3 phases of the hair cycle. A disruption in your hair cycle can give rise to loss of hair that s rapid and unexpected. Hair loss or alopecia can affect both men and women. 
So what can cause your hair to fall at an alarming rate?

The reasons behind hair loss could be many, but here are 6 major ones: 
1. Lack of protein in your diet
When you exclude protein from your diet, your body starts to conserve the protein that it has by altering the growth cycle of your hair. In such cases, your hair enters into the resting stage, resulting in zero hair growth. 
In India, 9 out of 10 people are said to suffer from low amounts of protein in their diet, with 91% vegetarians reporting protein deficiency.

2. Iron deficiency 
Iron plays a very important role in the transportation of oxygen to the different organs of the body. Lack of iron in your diet (which is the principle reason behind anaemia) can give rise to several health problems including hair loss. Your body attempts to direct oxygen to important organs so as to support their functioning. As a result, your scalp witnesses a low supply of oxygen, which causes hair loss. 


3. Vitamin D-3 deficiency
Deficiency of vitamin D-3 gives rise to a type of hair loss called Telogen Effluvium (TE). This is a temporary hair thinning phenomenon that takes place when the all the hair on your scalp enter the resting phase at the same time, subsequently causing you to shed a large amount of hair later on. 

4. Smoking 
Smoking can also affect the health of your hair, especially the rate at which it falls and the number of strands lost in a day. A research carried out by the Harvard School of Public Health has revealed that smoking can cause a rise in a hormone called dihydrotestosterone (DHT).
An increase in DHT level prevents new hair cells from growing and causes hair follicles to reduce in size with each hair cycle. As a result, the area on your scalp that gets affected by DHT experiences a lack of hair growth.  

5. Use of testosterone supplements in gym
Intake of testosterone in the form of supplements and injections to build muscle mass can trigger hair loss in men. This takes place when the testosterone in these supplements gets changed into DHT, thereby affecting your hair loss rate and amount. 

6. Past illnesses (dengue, TB and typhoid)
Falling of hair can also be brought on by illnesses such as typhoid, TB and dengue as the hair growth cycle comes to a stop. Hormonal or metabolic stress that is experienced during the course of such diseases may cause hairfall. 

What are the treatments available to cure hair loss?

1. Hair transplant
Hair transplant is a minimally invasive surgical technique that transfers hair follicles taken from other parts of your body to the balding area. Known by the name of Follicular Unit Transplantation, this hair loss treatment can help to bring back the natural appearance of a fuller head of hair. Hair follicles are harvested using two procedures- follicular unit extraction and strip harvesting. Procedure can vary from 4-8 hours or more depending on the case. 

2. Platelet- Rich Plasma (PRP)
Platelet- Rich Plasma (PRP) is another treatment alternative that can reverse hair loss. It s a simple non-surgical procedure that lasts about 60-90 minutes. In this form of hair treatment, the patient s own blood cells, more specifically blood platelets are injected into the scalp. Usually 8 sittings are required with each sitting being 2 weeks apart for better results.

3. Low Level Laser (Light) Therapy (LLLT)
This form of hair therapy utilises light energy of a specific wavelength and threshold to stimulate cellular activity, thereby promoting hair growth. Various controlled clinical tests have revealed its effectiveness in encouraging hair growth in both the genders.  




 6 Shocking Causes of Hair Loss + How To Combat this Problem

Dry skin is a condition caused by the lack of moisture in skin. Fine lines and wrinkles are just some of the conditions, which may be caused due to dry skin. Dry skin can also be very uncomfortable. The condition is mostly caused by environmental factors such as exposure to harsh weather conditions or getting soaked in hot water.

People at risk:
1. Age: People who are older than 40 years of age tend to be more at risk of dry skin than people who are younger than 40 years.
2. Climate: As mentioned earlier, weather conditions play a pivotal role in causing dry skin. Therefore, people who live in areas where the climate is either very hot or very cold tend to get dry skin more often than people who live in temperate climates. Low humidity is another factor which causes dry skin.
3. Profession: Some professions, such as nursing or hairstyling requires frequent usage of hot water all through the day, which can also lead to dry skin.
4. Swimming: Swimming is one of the major causes of dry skin. This is especially true in pools, which have chlorine. This is because chlorine increases the itchiness on your skin.

Treatments:
1. Lifestyle changes: Usually, lifestyle changes such as avoiding long, hot showers and putting moisturizers are good enough to make sure that dry skin goes away.
2. Lactic acid: Creams with lactic acid and urea can be prescribed by your doctor, if the dryness of your skin does not go away with moisturizers. These creams are usually over-the-counter medications.
3. Prescription creams: Prescription creams are given, only when conditions such as dermatitis, psoriasis or ichthyosis are present.
4. Wet dressing: Wet dressing is given only when dermatitis has set in, as it mostly help in preventing the infection.
4. Oiling: Oiling your body, especially with fish or flaxseed oil, ensures that your body does not succumb to dry skin.
5. Hand sanitizer: Normal hand sanitizers tend to make your hands dry. Thus, dermatologists recommend hydrating hand sanitizers that allow your hands to maintain their moisture. Therefore, whenever you are using a hand sanitizer, use a hydrating one.

Risks and Treatment of Dry Skin

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

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