Good morning I am Dr R Melitha, practicing as general physician at Rohini Delhi.
Now I am going to talk about most common topic which is which everybody knows that is PCOD. PCOD is Polycystic ovarian syndrome occurring in females affecting 5 to 10% of women, often effects in the age group of 15 to 45 years. Whenever you come across here, young fat girl having menstrual disturbance, facial hair growth, gain in weight, acne and if a young married woman comes across not becoming pregnant, it may be a case of Polycystic ovarian syndrome. Polycystic ovarian disease is a syndrome is characterized by excess of androgen production. Next is an ovulation and increase insulin resistant, how will the patient present a symptom, patient usually comes to the clinic having menstrual problems, menstrual problems are either scanty menses or they are not getting menses for 3 to 4 months. They come with hairy growth on the face, obesity, recurrent miscarriage, chronic pelvic pain that is pain in lower abdomen and they may come across with insulin resistant problem like hypertension, cardiovascular diseases and obesity and acanthosis nigerians that is pigment and patch, usually seen on the nape of the neck, the axilla and inner aspect of the thigh. Now you all come to know what are the causes which produces PCOD, causes are usually unknown, it is genetic it may be due to change in lifestyle, diet and stress. What are the pregnancy complications are with PCOD they are usually come with recurrent abortion, impaired glucose tolerance test, gestational diabetes that is blood sugar level usually high during pregnancy and small for deep babies which means the babies size do not correspond with the duration of pregnancy. Then out of diagnose a case of PCOD, PCOD is diagnosed by simply by doing ultrasound, ultrasound examination tells multicystic enlarged ovary or Polycystic Ovary with oyster wall effects. Secondly you can do blood test, blood test includes thyroid including hormones, fasting insulin level, triglyceride, cholesterol, testosterone, progesterone, FSH, LH and androgen level. How to diagnose, in case diagnose is done by these things what is the aim of the treatment of polycystic ovarian syndrome, aim of the treatment is reduce the symptoms, First is to reduce the weight, how will reduce the weight? Weight is reduced by exercise, diet, diet you have to have is which in carbohydrate, Omega 3 fatty acids, reduce calorie intake, reduce saturated fat and reduce cholesterol level. The next is to increase fertility, the patients usually come with not becoming pregnant, so do ovulation induction and in very rare cases you have to go for surgery to treat the polycystic ovarian disease syndrome. Secondly, you have to treat the fertility cases treatment of recurrent infection, diet advice, reducing cholesterol level and treatment of facial hair growth.read more
I am Dr R Melitha, practicing in general physician, practicing in Rohini and Gandhi Vihar.
Today my topic of discussion is regarding diabetes mellitus. Diabetes is one of the most talk about disease across the world, especially in India. WHO estimated that 80% of diabetes occurs in lower and middle income guys. India has more great result 50 million in term Type-2 diabetics which is called diabetes mellitus. And this is increasing in all mainly incidence in India. Now let me know what is diabetes, diabetes is a disease creates by hypoglycemia and glycosuria that means increase in blood sugar level and appearance of sugar in urine. It occurs due to deficient production or deficient absorption of insulin which comes in the pancreas. Now what are the types of diabetes, there are 4 types of diabetes, one is Type 1 Diabetes which is naturally called insulin-dependent diabetes, it occurs insulin childhood, it is insulin dependent, it usually asymptomatic, it is due to pancreas not able to produce sufficient insulin. Second is type 2 diabetes mellitus, it is a most common, it occurs in adulthood, it occurs due to deficient absorption of insulin, secondly, it also occurs due to change in lifestyle, not adequate exercise and diet patterns. Third is gestational diabetes, gestational diabetes is the diabetes increase in blood sugar level during pregnancy and such cases are likely to go into type 2 diabetes mellitus in the letustis, if they are not already suffering from diabetes before these. Last is pre-diabetes, Pre-diabetes is a condition in which blood sugar level is not that much high enough to be classified in Type 1 and Type 2. What are the symptoms of diabetes? Diabetes symptoms are usually classified as a track Polyuria, Polydipsia, Polyphagia which means increasing urination, increase in thirst and increase in appetite. Secondly, patient complaint of blurring of vision, they complaint of high blood sugar level, wound is not healing despite taking treatment. They may come with the nausea, vomiting, loss of weight, fatigue and where is may come with Sexual problems, may come with infections and they may come with skin problems. Secondly Dash investigate a case of diabetes there are three tests, four tests, mainly fasting blood sugar and postprandial blood sugar, fasting blood sugar is taken under is everybody knows, postprandial Dash 2 hours after breakfast heavy breakfast or after taking glucose Dash, which is normally 120 to 160 milligrams. Next is Oral GTT which is positive grade control the milligrams and continuous to this further and the last is HbA1C test which is the most important test then insulin which is like it Hemoglobin level, this gives the level of blood sugar level for the past 2 to 3 months that is 8 weeks to 12 weeks. How the diabetes is transmitted? Diabetes transmitted by genetic, due to recently due to change in Lifestyle, fat, diet, and poor exercise and family history, due to hypertension patient with hypertension, cardiovascular diseases also likely to develop diabetes. Now next is how will you prevent or control the diabetes, prevention starts with changing Lifestyle, diet pattern, exercise and taking care of body, taking care of skin and all other things and what are the complications of diabetes, complications it can affect major target organs like eye, kidney, liver, skin, nervous system and also causes hypertension and cardiovascular diseases and strokes. Is diabetes is curable everybody ask, unfortunately there is not any cure for diabetes but maintaining good exercise, healthy lifestyle, diet and taking medication on regular time you may lead a normal healthy life in diabetes. It is such a big topic, difficult to cover everything in short time.
If you have got any problem you can come to my clinic.read more
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Dr. R. Melitha provides answers that are knowledgeable, well-reasoned, professional and very helpful. Thanks mam for supporting mam is very knowledgeable. Quick response
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Thalassaemia, which is commonly referred to as thal, is a disorder of the blood which is inherited from the previous generation. This condition triggers the production of abnormal red blood cells in the body which in turn paves the way for chronic anaemia. Red blood cells play an indispensable role in carrying oxygen all through the body and hence any abnormality in this regard can result in thalassemia, the symptoms of which include, weakness all over the body, fatigue, faint and shortness of breath.
Understanding the type of thalassemia:
Thalassaemia is often thought to be an iron deficiency disease (anaemia), but can be differentiated with the aid of certain blood tests. This disease is a lifelong condition which requires efficient management. The type of thalassemia an individual is suffering from can be attributed to the number of faulty genes the person has inherited.
The two variants of thalassaemia are beta and alpha. In the case of alpha thalassemia, having one faulty gene would lead to no health problems while two faulty genes can cause mild anaemia. If there are three mutated genes, it will cause Haemoglobin H disease, and regular blood transfusions may be required. But an unborn child with four mutated genes will not be viable enough to survive the pregnancy.
The beta thalassaemia also comes in various forms. The beta thalassaemia major needs lifelong transfusion of blood and it is the most common form of thalassaemia across the world. The beta thalassemia intermedia do not have to depend on blood transfusion.
The treatment option for mild thalassaemia is entirely dependent on the type of the disease and how intense it is. When the disease is on a mild and minor level, then there may not be need of any comprehensive treatment. But at times, blood transfusions become necessary especially after undergoing surgery or when the thalassaemia causes complications.
People who are affected by severe levels of beta thalassaemia will require transfusion of blood from time to time. The treatment also causes an overload of iron and thus it is important to remove the surplus iron content. There are several oral medications available for this, and the healthcare provider can recommend suitable medications.
Managing moderate to severe thalassaemia:
Some of the most general methods of managing and treating thalassaemia include
- Frequent blood transfusions: When the thalassaemia gets too severe, it becomes necessary to opt for blood transfusion after every few weeks. The blood transfusion can cause iron build up with the passage of time. This, in turn, can affect the heart and lungs along with other crucial organs. Therefore, it is important to take medicines that can eliminate the extra iron.
- Stem cell transplant: Also referred to as the bone marrow transplant, the stem cell transplant can be the best bet. It is recommended for kids who are born with severe thalassaemia. This treatment option can mitigate the need of a lifelong transfusion of blood and intake of drugs for controlling the iron overload.
If you thought that chest pain occurred only due to a heart-related issue like a heart attack, you are wrong. Chest pain is one of the most common reasons that people visit the emergency services and it can be caused due to problems with your heart, lungs and digestive system.
Chest pain can be due to either of these two main reasons:
Heart- related Issues
1. Heart attacks called myocardial infarctions are very common reasons for chest pains. During a heart attack, the blood supply that serves the heart with oxygen is cut off due to plaque build-up in heart arteries causing the death of heart muscles.
- Other reasons for heart attacks are blood clots or torn blood vessels.
- Not all people having a heart attack have symptoms. Usually, people report symptoms like chest pain, upper body pain, nausea, sweating, fatigue, and trouble breathing.
- A heart attack is a serious medical emergency for which immediate care is needed.
2. Angina pectoris is a type of chest pain that results from reduced blood flow to the heart. Low blood flow means your heart doesn’t get enough oxygen. The angina pain is often triggered by physical activity or emotional stress and feels like a vice squeezing your chest or a heavy weight on your chest. It can also spread from your chest to your neck, arms, and shoulders. Other symptoms are fatigue, dizziness and nausea and these normally last up to 15 minutes only.
3. Unstable angina which causes crushing chest pains suddenly and even when you are not doing anything strenuous is a medical emergency as it can lead to a heart attack. This usually shows that your heart, arteries are narrowing alarmingly.
Other heart-related reasons for chest pains are-
- Mitral valve narrowing or stenosis
- Heart arrhythmias
- Coronary Artery disease
- Inflammation of heart muscles or pericardium and weakening of the heart muscles.
All of these are emergencies and need immediate medical attention to prevent a fatality.
Not Heart- related:
1. Lung conditions like Pneumonia, Bronchitis, Pulmonary embolism.
- Pneumonia is an infection in one or both lungs caused by fungi, bacteria, or viruses. It causes inflammation in your lung’s air sacs and makes them full of pus which makes it difficult to breathe and causes chest pains, amongst other debilitating symptoms.
- Bronchitis is an inflammation of your bronchial tubes. It can be chronic or acute and it can cause a cough with mucus and chest pains.
- Pulmonary embolism is a blood clot that occurs in the lungs. It can go on to damage parts of your lung due to limited blood flow. Apart from this, it can also decrease oxygen levels in the blood and affect other organs.
It can be life-threatening due to permanent lung damage. The most common symptom of a pulmonary embolism is gradual or sudden shortness of breath.
There is also-
- bluish skin tone
- hest pain that extends into your arm, jaw, neck, and shoulder
2. Rib cage inflammation or Costochondritis is also known as Tietze’s syndrome. It is an inflammation of the cartilage in the rib cage. Patients experience chest pain in the upper and middle rib area on either side of the body due to this. The pain can also radiate to the back or the abdomen, getting worse if you move, stretch, or breathe deeply.
3. Food pipe disease or Esophagitis is any inflammation or irritation of the oesophagus, a tube that sends food from your throat down to your stomach.
GERD- This condition occurs when the stomach contents and acids back up into the oesophagus. This causes chest pain that can mimic a heart disease. There may also be oesophagal spasms due to GERD. In case you have a concern or query you can always consult an expert & get answers to your questions!
The term wellness is much more than just physical health, exercise or nutrition though has been applied in many different ways. Wellness is a developed process of achieving one’s full health and well-being potential.
There are several models of wellness. A few known and accepted ones postulate six or seven aspects:
- Physical wellness
Wellness actually involves a personal perception of general wellness by the self. We score our wellness from 1-10, with 1 being worst ever and 10 being best ever score. We may all have different answers when our doctor asks us. How are you feeling today on a scale of 1-10?
So what can we do to enhance our general wellness? This is where a health or wellness coach comes in. Think of wellness coaching like this, many of us have health goals that we would like to achieve or a disease that we want to overcome, but a lot of times do not know where to begin making changes to reach those goals. Hence we need handholding to reach our wellness, health and weight loss goals- all of which the coach does for us. A wellness coach helps by challenging patients to develop their inner wisdom, identify their values, and transform their goals into action.
General wellness coaching in hospitals - What to expect?
A health and wellness coach is available in most hospitals today. An initial visit with the coach will help you set realistic goals especially if you are grappling with a health issue like diabetes, hypertension, heart problem or stress. The coach will also do an analysis of your current routines and habits, followed by recommendations for healthy changes designed around your particular lifestyle. Follow-up appointments will be conducted to monitor your progress and ensure that you stay on track. The health coach will help you to continue with slowly implementing healthy changes into your daily routine.
Wellness coaching uses principles from positive psychology and the practices of motivational interviews and goal setting.
A wellness coach can help you with
- Weight loss and weight management is as we know is very helpful for people with diabetes, osteoporosis and heart disease.
- Eating right can help manage various disorders. This will include tips to cut down on bad cholesterol generating foods and low-fat foods for heart patients and low calories and low sugar foods for diabetics.
- Improving physical activity helps in managing diabetes, heart disease and improves joint pains. The coach will guide you towards the programme that will help you manage your health condition in the best possible manner.
- Strength training helps people with poor muscle tone to develop a better frame. It is highly recommended for older people.
- Coach will tell you what to eat and how much to eat for lowering blood pressure.
- Wellness coaching is an important link between you and your doctor so go ahead make an appointment with one right away to optimise your wellness.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I ordered afternoon 2 pm biryani and ate. Night by 10 pm severe stomach pain started, so far 4 times went to toilet like watery stools coming. Still having stomach pain. Suggest medicines for me.
Sir, I'm manikandan. I need to gain Muscles Body weight to 60 kg. Around 12 kg needed for that. I take around 2700Kcal Food But still my body weight does not increase a penny Grams. What I do for gain Weight Immediately.
I am feeling cold at least once a month. I have doubts whether my health is right. Why is this at least once a month comes cold. What should I do for that?
An apple a day keeps the doctor away” however, while one may commend you on an excellent diet schedule, keeping the doctor away might not always seem to be too favourable an option, especially in recent times when unforeseen circumstances and complications pertaining to lifestyle irregularities always keep creeping up.
While proper diet and regular workouts may keep you remarkably fit, genetic constraints might easily overrule such efforts to maintaining good health. Frequent checkups are especially recommended for those who share a family history of a number of diseases, infections, any type of cancer, hypertension, or sleep disorders, since problems might grow quietly and steadily when left unchecked for a longer span of time.
Most people usually visit their doctor or physician when they face an emergency. This should not be the scenario, as is advised by most health experts. It has been widely accepted that the average visit to the clinic must be at the least, four times a year. However, uniformity isn’t to be maintained by everyone in this regard. Infants see a doctor for at least eight times a year while six to eight year olds visit their physician twice a year.
It is important to have a number of crucial matters looked into and tested periodically in order to keep track of any unfavourable developments:
- Dental check-up every six months
- Annual pap smears
- Semi-annual HIV tests
- Eye examinations once every two years, once a year for those patients with current vision problems
- Biennial skin cancer screening
- Full physical examination once a year
- Breast examination once a month
- Pelvic examination every few months
- Thyroid tests every five years
- Check blood pressure level every month
It is imperative to understand that not one particular check-up schedule is capable of fitting in the necessities of all individuals. This makes it all the more clear that, while the requirement of physical attention isn’t the same for everyone, once a year physical check-up is a must for any individual.
In case you have a concern or query you can always consult an expert & get answers to your questions!