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 talk about 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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After eating a meal to your heart’s content, it is very normal to burp or belch. However, it is normal only when it happens occasionally, or after a meal, for someone used to a contented meal every single time. On the other hand, excessive burping or belching can happen due to two reasons.
- Excessive air intake: There are multiple ways that excessive air can reach the food pipe. Sucking on straws, chewing gum constantly and ill-fitting dentures are some common reasons for burping.
- Digestive problems: Ulcers in the stomach, prolonged gastric, gallstones and rarely, esophageal or stomach cancers can also cause burping.
When to see a doctor
Check with a doctor if you have persistent burping, followed by a meal or otherwise, and accompanied by the following symptoms.
- Go slow when eating and/or drinking: Most of us are pressed for time and eating and/or drinking has now become a task that needs to be finished quickly. Eating fast causes air to be swallowed, and therefore one of the best ways to stop burping is to eat slowly. Sitting in a calm, relaxing environment when eating also allows one to enjoy the food and avoid or stop burping.
- Avoid taliking while eating: There is always so much to catch up, whether at home or outside. So, talking while eating is a common practice. This is not just bad manners, but there is also a lot of air that is swallowed, which leads to burping. A solution is to chew the food properly, which not just helps stop burping, but also aids in better food digestion by mixing it adequately with saliva.
- Substitute coke with water: Carbonated drinks are another reason for belching. Replacing them with water, tea, or anything noncarbonated is advisable, not just from burping perspective, but also from the excessive sugar consumption. Carbonated drinks are just sugar solutions, and are absolutely of no nutritive value.
- Avoid straw: When possible, drink from a glass and avoid straws. This reduces the amount of gas taken in and helps stop burping
- Quit smoking: Quitting it has multiple health benefits, and getting rid of smoking is just one of them.
- Dentures: Ill-fitting dentures can be a reason for belching, and so they should be checked and corrected, if required, in a person who has persistent burping.
- Chewing gum: Constantly chewing gum contributes to burping, and so avoiding chewing gum or sucking on hard candy is another way to control burping.
- Avoid certain foods: Foodstuffs like broccoli, cauliflower, lettuce, sprouts, and lentils can produce excessive gas and should be avoided in people who have persistent burping.
Follow the above steps in your daily routine; still if your burping problem persists, it is time to consult your physician.
Almost all of us have experienced bloating, gas or an upset stomach. Yet some people experience this problem at a chronic level. Gas occurs in the stomach and intestines due to breakdown of food into energy. All of us pass gas, however some people do more than others. An average person passes gas 5-20 times a day.
An upset stomach can often cause problems and can be a difficult battle for many people. Although the symptoms of gas problems often relate to an improper diet, yet other factors may be also responsible.
Causes and Symptoms of Gas Problems
- Swallowing air: The swallowed air which is not burped out, passes through the digestive system and is released through the opening of the anus. Hiccups can also occur if you have swallowed excessive air.
- Diet: The reaction of different foods varies from one person to another. Also foods that lead to odorous gas may also vary from person to person. Yet, spicy foods and dairy products are the most common causes of gas. Example - Beans, cabbage, onions, radishes, eggs, carbonated drinks, sugar, packaged foods etc.
- Medications: Certain medicines and supplements, including prescription drugs, can lead to gas problems and bloating. Further, medications which change the hormonal balance in the body can also cause bloating.
- Medical problems: Certain medical conditions such as Irritable bowel syndrome or bowel obstruction can also lead to an upset stomach.
Common symptoms of gas problems include gas pain, cramping, bloating, diarrhoea and constipation. In the worst of cases, gas and bloating indicate colon cancer. Such people experience rapid weight loss, anaemia and blood in stools.
Modifying your lifestyle, in particular your dietary practices, is essential to a healthy recovery.
Diabetes might not be the end of the road for you. While it is a chronic disorder, there are a number of steps you can take to minimize its effects. Before that you should know what diabetes is and its various types.
What is diabetes?
Diabetes is a metabolic disorder where the sugar in your blood is not metabolized by the body. This leads to a situation wherein sugar accumulates in your blood; this condition is known as high blood sugar. Now this can happen in two ways:
Type 1 Diabetes: In this type, the beta cells of the pancreas that produce insulin (hormone that metabolizes sugar) are destroyed by the immune system of the body. This leads to reduction in insulin levels, causing blood sugar to shoot up.
Type 2 Diabetes: Type 2 diabetes is a condition wherein the body cannot effectively utilize the insulin to metabolize sugar. This again leads to accumulation of sugar in the blood.
Now that you know the various types of diabetes, it is time to focus on the preventive measures. The various tips for high blood sugar level are:
Steer Clear of Sugar: Think of sugar as your enemy, as it is something that you have to stay away from. Sugar will only add to the high blood sugar content that you are already diagnosed with.
Welcome whole grains with open arms: Refined grains are a big no; that means no more of those delicious white bread sandwiches. Instead, opt for whole grains such as brown bread, brown rice and oats. Refined grains come under simple carbohydrates that cause your blood sugar levels to shoot up.
Avoid over consumption of fruits: While fruits are healthy, they do contain fructose which is again, a form of sugar. So, yes eat them but limit their consumption to one serving a day.
High time you realize nothing substitutes exercise: Regular exercise can help you burn calories and also keep your blood sugar levels low. It allows you to maintain healthy weight levels and improves your overall wellbeing.
Take no stress: Stress has been shown to increase blood sugar, so if you are feeling stressed and can’t seem to get out of with, take steps to deal with it. Practice relaxation techniques such as meditation that can help you reduce stress and improve focus.
Asthmatic patients often find that the frequency and intensity of asthma attacks increase with a change in weather, as the challenges two-fold for asthmatic patients. If they are indoors, they inhale triggers such as dust mites, mould etc. and if they step outdoors, the outside air acts as a trigger for an asthmatic attack. However, there are ways to make your life easier.
- Curb allergy triggers inside your house: While you can’t do much about the weather, you can control the environment inside your house. Limit your time around pets that could trigger an attack and try keeping them outside the bedroom. Use dust proof covers on mattresses and pillows and changes your bedding regularly. Though it may look cosier, avoid using a lot of pillows and throw cushions on your bed. Clean and replace the filters of your home’s heating or cooling system before you start it up for the first time. The filters should also be regularly checked and cleaned throughout the winter.
- Ventilate the house: Keep your house dry and cool at all times to prevent the growth of mould and dust mites. To do this, run an exhaust fan in the bathroom while having a shower and in the kitchen while cooking. As far as possible, do not dry clothes indoors.
- Avoid too cold or too hot air: As far as possible avoid going outdoors especially on windy days. Instead of going for a walk outdoors, exercise at home or in a gym. When you go outdoors, drape a scarf over the lower half of your face to cover your nose and mouth. This will ensure that you do not breathe in too cold air or too hot air.
- Breathe correctly: As children, we’re told to keep our mouths closed. Not only is this good social etiquette, but it also prevents you from breathing through your mouth. The nostrils have tiny hair inside them that act as filters and keep dust particles and pollen from being inhaled. This also warms up the air while being inhaled. Thus avoid breathing through your mouth and instead only breathe through your nose.
- Take your medications: Create an effective plan of action to be followed in case of an asthmatic attack and get regular check-ups throughout the season. If you notice your symptoms worsening as the weather gets colder, talk to your doctor about changing your medication and its dosage. Do not skip your medication or stop it unless your doctor tells you to.
In case you have a concern or query you can always consult an expert & get answers to your questions!
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:
- 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!