Inamdar Multispeciality Hospital

A number of digestion related problems plague people from time to time. Diarrhea or loose motions remains one of the most debilitating problem in this regard, with other conditions like IBS or irritable bowel syndrome and colitis, Crohn’s Disease and others like pain, discomfort and related issues. If your daily schedule is hampered by constant trips to the bathroom and your eating habits show poor nutritional choices and a lack of appetite, then it may be time to do something about these digestive problems.

Let us acquaint ourselves with a few measures for treatment of the same.

1. Triggers: One of the important and primary steps in the process of treating your digestive related problem is to learn how to recognise and identify the triggers so that you may avoid the same. There are many kinds of food that may not be suitable for some people. With the help of your doctor, you can go through a food or skin test that will help in exposing you to small amounts of various ingredients. The results will help in pointing towards the food allergy or triggers that you may be suffering from. Apart from food, there may be certain kinds of medication that may be causing side effects like loose motions and other digestive problems. Also, there are certain situations and stress giving factors that may be contributing to this condition. In such cases, it is best to maintain a food dairy or event diary so that you learn your triggers and avoid the same.
2. Hydration: One of the most important ways of treating digestive problems is to drink plenty of fluids and to keep your body well hydrated. Besides routinely flushing out the toxins that cause the condition in the first place, plenty of water intake will also help in replenishing the lost fluid reserves as the body tends to get dehydrated swiftly when it is suffering from such conditions. One should also avoid contaminated sources of water and try to drink bottled and packaged water, especially while travelling.
3. Hygiene: It is important to eat hygienically prepared food and wash your hands before and after meals so as to remove unhygienic triggers from the list that causes digestive disorders. Using alcohol free wipes in case you are suffering from loose motions and keeping a sanitiser handy at all times will also help in treating the condition.
4. Medicines: The doctor may prescribe various kinds of medicines in order to fight the onset of such conditions as well for treatment of related symptoms like bloating and gas. This medication must always be kept handy so that the patient can have it as soon as the earliest symptoms arise.

Heat treatment or thermotherapy is an effective process of healing from a sports injury. Understanding the when and how to use heat treatment is essential since it can even prolong the process of healing.

The Process Of Healing-

There are three stages of healing. The first phase is called the inflammatory phase. The goal for this phase is to ensure that no further damage happens to the affected area. It is during this phase that the swelling and the buildup of fluid happens. Heat treatment is not applicable here since it increases the blood circulation and can lengthen the healing process. The second phase is called proliferation. This is the phase where the introduction of scarring and new tissue takes place. This is the post-injury phase and heat treatment greatly helps during this time. The third phase is known as remodelling. It is the time when the new tissue matures and settles down. Thermotherapy can be applied in this phase as well.

Injuries that are treatable through thermotherapy-

Heat treatments are extremely effective in injuries such as muscle spasms along with back strains. It can also be applied to joint injuries related to a thumb, turf toe, elbow, wrist sprains and sprained ankles. The reason why heat treatment is effective in joint injuries is because heating significantly heats the bone and improves the range of motion. The idea behind any heat treatment is to make the tissue more extensible by warming it up. Exercises related to a range of motion should be performed for 15-20 minutes post the heat treatment.

How heat treatment helps in treating sports injuries?

1. Heat treatment significantly increases the blood circulation and help to eradicate dead skin and other toxic bodies from the origin of the injury.

2. It assists in metabolism of the cells.

3. It increases the capillary permeability.

4. It increases the number of nutrients and oxygen to the source of injury and speeds up the process of healing.

5. Heat treatments can cut down muscle spasms.

Types of Heat Treatments Available:

For heating deep tissues, ultrasound is the best form of treatment. It can penetrate up to 1.5 inches inside the skin. Basic strain injuries such as hamstring and rotator cuff are instantly treatable with ultrasound. This being said it is one of the most expensive methods of heat treatment. Then there is superficial heat therapy. This is convenient and readily available. They directly transfer heat from the source to the injury location. Common examples of these are a hot tub, paraffin bath and hot bags. The third type of heating mechanism is known as dry hot packs. They produce a steady source of heat and are run by either microwave or electricity. Caution should be taken in order to ensure that the heat does not burn the upper layer of the skin.

During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed early menopause.
Causes: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.
Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:
- Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
- Irregular cycles before complete cessation of the menstrual cycles.
- General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
- There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
- For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
- Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
- Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
- Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.
There is also a good news, that after menopause women are at lesser risk of cancer - especially breast and ovarian. 
It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it - especially if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.
It is easier said than done, but one of the key ways to handle premature menopause is an open discussion.

Pregnancy brings with it a new set of additional responsibilities. The mother has to be extra vigilant about monitoring and caring for her health. This ensures that sufficient nutrition is being provided to the growing infant, at the same time, ensuring no harm comes through you. Listed below are some simple ways to do the same.

1. Prenatal care: As soon as you realize that you are pregnant, it is advisable to talk to a doctor or a midwife about proper prenatal care. This could include anything and everything from prenatal vitamins to food habits to exercise to sleeping habits to periodic scanning – the whole hog.
2. Diet: You need to ensure two things: that you are eating enough for two people, and also that everything is healthy and not harmful for the little one that gets all its nutrition through you. The diet should be healthy, nutritious, wholesome, and of course free of junk. Some pointers to a healthy diet include:
   • Include a good amount of fruits and vegetables every day; break it into five small portions.
   • Sufficient amount of carbohydrates should be the basis of each meal.
   • Whole grains are preferred to white grains, which also give good amount of fiber.
   • A good amount of proteins including fish, eggs, meat, nuts, pulses, milk, and other dairy products.
   • Ensure adequate amount of iron, calcium, and other minerals are included in the diet.
   • Avoid eating non-pasteurized dairy products, uncooked or undercooked food, and smoked seafood.
   • Folic acid is compulsory for the first trimester as it helps to protect your unborn baby from developing neural tube defects such as spina bifida. Also, it helps to prevent other birth defects, such as a cleft palate . 
3. Weight gain: If your weight was normal for your age and height before pregnancy, expect to add about 12 to 15 kg during your pregnancy. Consult with your doctor on weight changes and nutritional aspects to monitor weight throughout pregnancy. This could change based on if it is twins, your weight before pregnancy, and body type.
4. Exercise: There are specific exercises designed to benefit the pregnant women. Whether it is walking or swimming aimed at improving overall health or Kegel exercises aimed at improving vaginal and perineal muscles, your doctor should be able to draw up a routine. Exercising while pregnancy is being increasingly encouraged for the following reasons:
   • Improved energy levels
   • Controls back pain
   • Improved sleep pattern
   • Improves constipation
   • Improves muscles strength and endurance
5. Lifestyle changes: With pregnancy setting in, it is time to bid goodbye to smoking and drinking alcohol. Continued smoking after onset of pregnancy has many serious complications, including growth retardation, low birth weight. Alcohol can lead to miscarriage, stillbirth, and premature delivery.

These are simple ways to monitor and care for your and of course, the baby’s health throughout pregnancy.

Have you undergone cartilage damage recently and are seeking ideal treatment measures? Cartilage damage is a common form of injury that involves your knees. Other joints such as the ankles, elbows and hips may also be affected by cartilage damage. Cartilage, the tough and flexible tissues covering the surface of your joints, acts as a shock absorber, allowing the bones to slide over each other. Cartilage damage may occur because of injuries such as a gradual wear, sports injuries and osteoarthritis. While acute cartilage damage may heal on its own, severe damage may need treatment via surgical measures.

Treatment

Physiotherapy

• Physiotherapy is effective when you experience difficulty in moving your affected joint.
• It is also an important part of recovery if you have to undergo surgical procedures for treating cartilage damage.
• A physiotherapist will teach you certain exercises that are effective for strengthening the muscles that surround and support your affected joint.
• This helps in reducing pain and pressure on the joint.

Surgery

• Severe and serious cartilage damage does not heal effectively on its own, and a surgery may be required for treatment.
• Usually, surgery is performed by using Arthroscopy. This is a form of keyhole surgery in which certain instruments are inserted into your affected joint via incisions or small cuts.
• In some cases, larger incisions have to be made.
• Such surgeries are carried out after giving general anesthesia to the patient.

The most common surgeries that are undertaken in cases of cartilage damage include the following:

Lavage and debridement

• In this form of surgery, your joint is cleaned for the removal of any loose tissues.
• The damaged edges are trimmed to be made smooth. Sometimes, the damage may also be repaired during the same time.

Marrow stimulation

• In this procedure, tiny holes are made on the bone beneath your damaged cartilage that releases the bone marrow in it.
• The marrow cells stimulate the production of new cartilage.

Mosaicplasty

• In this procedure, small plugs of healthy cartilage from areas of a joint that are non-weight bearing are removed and used for replacing areas of the affected cartilage.

Osteotomy

• This procedure involves the alteration of the alignment of your leg for reducing pressure on the damaged area.
• It is effective in improving pain.
• A wedge of bone may be removed or added from your thigh bone or shin bone.
• The bone gets fixed with a plate till it gets healed.

In some cases, a joint replacement surgery has to be carried out. In this procedure, the entire affected joint is removed and replaced with an artificial joint. Hip replacement and knee replacement are common examples of this kind of surgery.

Fear, anxiety and stress can often lead humans to either escape the situation or fight it by defending themselves. But there are other behaviours that humans turn to when they are under stress. This is not unnatural at all; we all face it at some point in time. What’s more, even dogs revert to the four Fs when under stress. Let us find out what are they and also how to deal with them.

1. Fight: Fighting back is the natural reaction, which we turn to when we want to defend ourselves. Shouting at someone might give you some confidence for the time being. But again, it is not a permanent solution. We might end up apologising for our behaviour later but do nothing to address the situation that brought about that kind of behaviour.
2. Flight: This is the escape mode that we turn to when we want to avoid a certain person or scenario, that might lead to stress. However, it must be remembered that, fleeing stress will help in fixing it temporarily. But since the situation remains unchanged, it will keep happening again and again.
3. Freeze: For some people, the shock is so overwhelming that it becomes difficult for them to react at all. They simply freeze. The person goes into the panic mode and fails to move or say anything.
4. Fool around: This option seems to be not a very bad idea in times of stress and anxiety depending on exactly what you mean by fooling around. If you can crack a joke at a tensed situation and lighten the mood, it helps immensely. However, if your idea of fooling around is to avoid talking about the situation and instead have fun, talk about other silly things, then it might not be a good idea.

Dealing with stress is not easy, but if you have realised the cause for your stress, your problem is half solved. If it is something you can change, then start working on it. If not, then it is best to let things happen in their own sweet way, while you change your attitude towards it. If you have realised what kind of behaviour your turn to when under stress, it is easier to face the situation. Listen to some of your favourite music, wear clothes that make you feel good and think about the situation and the possible solution later. Don’t let stress get to you, face situations, keep calm and be positive!
 

The sunscreen acts as a layer of defense against sun radiation and keeps it from causing any damage. It is tremendously important to stress upon the importance of using sunscreen. Using a sunscreen every time you step outdoors and using it correctly is of vital importance to have healthy skin. No sunscreen provides absolute protection from the harmful rays of the sun, but using the right product in the right way will take you far in shielding yourself from their harshness.

Two important facts about sunscreen are:

1. You don't need to apply sunscreen if your makeup contains SPF - If any of your makeup products like foundation or powder contains SPF, do not assume that it can replace your sunscreen. Makeup containing SPF cannot protect your skin entirely as cosmetics are generally applied lightly and mostly doesn't cover places like T-zones, earlobes or hairline. To fully shield your skin from the sunrays, it's necessary to apply sunscreen or moisturizer with at least SPF 30 before putting makeup on. It is advisable to apply the sunscreen half an hour before stepping out for maximum benefit.
2. You do not need to apply sunscreen in winters or when you are indoors - Winter skin is relatively more sensitive than summer skin which is tanned. If one is in hilly areas or snow covered regions there is reflection of UV light from the snow that causes more skin damage. Also glass can allow UV rays to pass through and indoor lighting can also be a source of UV exposure, therefore you should apply sunscreen even when you are indoors.

Following are the do's and don'ts you need to follow before you apply sunscreen:

1. Do: Choose a sunscreen that is, at least, SPF 30+: That is the minimum protection that your skin requires. And if you must stay outdoors for an extended period of time, opt for a product with a higher SPF rating.
2. Do: Apply sunscreen 15-30 minutes before going outdoors: For the product to be most effective, it needs to be fully absorbed by the skin before exposure to the sun; the reason why applying approximately 30 minutes before you step out of home is a must.
3. Don't: Apply sunscreen only on the face: Make sure you apply it to every part of your body, especially the hands, forearms, thighs and ears, which are commonly exposed to the sun. Not only are these more prone to skin ageing, but the risk of melanoma (skin cancer) is also tremendously high in these portions of the body.

Ulcerative colitis is a chronic inflammatory condition whereby, tiny abscesses and ulcers are formed on the inner lining of the large intestine, or on the colon or rectum. These ulcers may burst frequently resulting in diarrhea and bloody stools. This disease may also be responsible for causing anemia as well as harsh abdominal pain.

Ulcerative colitis normally alternate periodically from flaring up to receding quickly. These periods of remission can either last for weeks or maybe, even for years at a stretch. They are, however, not permanent and although the disease may seem to have disappeared completely, it can soon show up again in no time. Usually beginning in the rectum, it can, by and by, spread rapidly to other parts of the colon. If it is, however, limited only to the rectum, then it is more commonly referred to as ulcerative proctitis.

Surgery is generally obligatory and mandatory when it comes to treating ulcerative colitis. If surgery is not performed, you may suffer from long-lasting side effects, including cancer and colon rupture. Here are the different types of surgery that you may undergo:

1. Colectomy: This is done when the entire colon needs to be removed and is usually performed to eliminate the perils of acquiring colon cancer.
2. Proctocolectomy: This concerns the total removal of both colon and rectum and is usually the standard procedure when dealing with ulcerative colitis.
3. Ileal Pouch Anal Anastomosis: If the treatment does not require a permanent stoma, and if you can still manage to let out stool from your anus, then this surgery, also called restorative proctocolectomy would be most appropriate.

Here, both colon and rectum are removed, but at the same time, the small intestine is utilized to form an internal reservoir, called a J-pouch, which is linked to the anus and can hereafter serve as your new rectum.

Sinusitis or sinus infections can be quite a debilitating ailment when it becomes recurrent. Sinuses are cavities within our head just behind the nose which extends up to our forehead and to certain areas of the cheeks. These cavities are filled with a mucosal lining which helps you breathe and also filters the air which goes to the lungs. When the mucosal lining gets inflamed, it blocks the normal drainage of the mucus into the nose. This results in headaches, nasal polyps and general discomfort. Homeopathy offers some great remedies for this condition, without side effects. Some of these are discussed below.

Homeopathic remedies for sinus problems

1. Belladonna: This medication is very effective when the sinusitis has resulted in a suppressed discharge from the nose which occurs intermittently. If you have a splitting headache which feels unbearable, Belladonna can help relieve the symptoms quickly. If the infection of the sinus has spread to the throat and results in cough, Belladonna can be equally effective in those circumstances as well.
2. Pulsatilla: If you are experiencing a greenish mucosal discharge from your nose without a painful burning sensation within it, Pulsatilla can be a very effective cure. Another indication where this medication is very effective is when you have headaches centered just above your eyes rather than over the forehead or other parts of your face.
3. Kali Bichrome: This is another commonly prescribed medication to deal with the symptoms of sinusitis as well as to reduce inflammation and cure sinusitis altogether. If you have a lot of mucosal discharge that drops into your throat along with discharges through the nose, Kali Bichrome is the drug to go to. Other indications where it is effective are pain and heaviness in the nose and the inability to breathe with headaches in and around the eyes.
4. Silicea: If you are feeling cold and constantly chilly along with nasal stuffiness, Silicea is the medication to go to. Along with discharges, your nose may form hard mucous crusts within it. Trying to manually remove these crusts may also cause bleeding. Silicea will reduce these symptoms and is also effective in reducing a headache which occurs mostly on the left side of your face.
5. Merc Sol: If you are experiencing a yellowish green discharge from the nose along with a burning sensation and increased saliva secretion in your mouth, Merc Sol is the remedy to turn to. It is also effective wherein the headache has spread all around the head.

Heart failure occurs when the heart fails to pump blood around the body and organs for oxygen and nutrients. As blood moves through the heart and body at a slower rate, pressure in the heart increases. The chambers of the heart stretch to hold more blood to be able to pump through the body. This helps the blood to move but eventually the heart muscle walls weaken, unable to pump blood efficiently. The kidneys, in response cause the body, to retain fluids. The leakage of fluid in the tissues and the organs congests the heart, leading to heart failure.

Any of the following conditions can be responsible for weakening the heart and causing heart failure.

1. Coronary artery disease: this is a disease of the arteries supplying blood and oxygen to the heart that causes decreased blood flow to heart muscle. If the arteries get blocked or narrowed (due to the buildup of fatty deposits), the heart fails to get oxygen and nutrients, which may eventually lead to heart failure.

2. Heart attack: if the artery becomes suddenly blocked or the plaques formed by fatty deposits rupture, it can lead to a heart attack. This happens due to the formation of a blood clot which may block blood flow to an area of heart muscle.

3. High blood pressure: high blood pressure puts an extra strain on the heart for it to work harder to circulate blood throughout the body. As a result, the heart muscle may become stiff or weak to effectively pump blood.

4. Heart muscle weakness: this condition can have many causes including diseases, infections, drug and alcohol abuse. Genetic factors may also contribute to the weakening of heart muscles.

5. Other diseases: chronic diseases like diabetes, HIV, hyperthyroidism or a buildup of iron or protein can also lead to heart failure.

Acne is an inflammatory skin disorder which is prevalent in both males and females. When the sebaceous glands present on skin produce excessive sebum, the hair follicles present on skin get clogged leading to the formation of acne.

Acne can be triggered by a number of factors. Here are some of the common triggers for acne:

1. Genetics: If one or both parents have acne, their children have high chances of suffering from it as well. Genes influence the sensitivity of your skin towards hormones such as androgens and progesterone that trigger acne. They also influence the production of anti inflammatory chemicals in the skin and skin's response to bacteria.
2. Stress: The severity of acne can be correlated to the levels of stress a person is facing. While scientists are yet to figure the exact relationship between stress and acne; it is known that the cells that produce sebum or oil also act as stress receptors. Studies suggest that when a person is under stress, these cells produce excessive sebum that clogs pores on the skin leading to pimples.
3. Hormones: Hormones play an important role in skin health especially when it comes to women. Androgens or the male hormones present in both men and women, trigger acne by over stimulating the oil glands. Women may also see an increase in pimples during menstruation. This is due to the fluctuating levels of progesterone that stimulate the production of sebum.
4. Medication: Acne is one of the side effects to a few types of medication such as corticosteroids and anticonvulsants. However, this is not seen very often. On the other hand, drugs that contain hormones such as androgenic steroids almost always cause an acne breakout. Treatment for acne depends on the severity of the condition and its persistence. Mild cases can be easily treated with over the counter medication, but if your acne is severe and not affected by these medications, it best to consult a dermatologist.

Foot problems are common among all people. Some foot problems are minor while some are severe and require immediate medical attention or surgery for treatment.

Here are some common foot problems, which require surgery:

1. Bunions: These are bony lumps, which develop on the side of a foot and also at the base of the big toe. Bunions occur due to a condition called hallux valgus. This causes the big toe joint to bend in the direction of the other toes, resulting in deformity. This condition requires surgical correction. The surgery required is known as osteotomy, and it involves the straightening of the big toe and metatarsals.
2. Hammertoes: Hallux valgus may result in your other toes being clawed or bent permanently. This condition is called hammer toes.

The damage can be eased by:

1. Arthroplasty: It involves the removal of a deformed joint between the toe bones, resulting in joint flexibility.
2. Arthrodesis: This process fuses the phalange and makes the toe stable.
3. Metatarsal surgery: In some cases, the forefoot joints may get damaged due to the inflammation of the joint lining or synovitis, which results in arthritis. These joints are called metatarsophalangeal joints and they can get dislocated due to arthritis damage. Pain and discomfort are felt. Surgery is required when the symptoms are very severe and other treatments fail. The nature of surgery depends on the severity. The most common surgery is done on the big toe to remove the heads of the metatarsophalangeal joints.
4. Ankle arthritis: This condition occurs because of osteoarthritis. The cartilages, which cover the ends of the bones roughen and get thin, which further thicken the bone underneath. It also results because of other rheumatic conditions. Pain and swelling is caused with an occasional joint deformity. Surgery may be required when the symptoms are very severe. The three major surgical options for treating ankle arthritis are ankle fusion, triple fusion and ankle replacement.
5. Achilles tendon disorders: The Achilles tendon accounts for being the largest body tendon and great force is put through it when moving the lower leg muscles. This wears down with old age and causes swellings within the tendon accompanied by pain. Sometimes, surgery is required for fixing this condition.
6. Morton's neuroma: This is a painful condition in which a nerve that gives sensation or feelings to the nearby toes is affected. The nerves are affected in the third and fourth toes. In case the symptoms are severe, a surgery is required.

Foot problems are prevalent in many people and they may occur due to various conditions or reasons. In case of severe symptoms, some foot problems require surgery for treatment. The most appropriate surgical method should be undertaken.

Heel pain is a common problem in the body where the affected person experiences pain radiating from the heel bone. Heel pain usually progresses slowly over time, it is recommended to consult a medical professional, if heel pain turns severe. The pain tends to be most severe after one has been inactive for some time such as after waking up in the morning. 

Causes 

Heel pain is usually caused when tissues present in the bottom of the heel (Plantar fascia) is inflammed. These tissues connect the heel bone with the bones of the feet and acts as a shock absorber. Tears form in these tissues when they are damaged or when they get thicker. These tissues are at an increased risk of wear and tear for those who are over 45 years old. The risks also tend to increase if the person is obese or whose occupation requires standing for lengthy periods of time. 

Among other causes of heel pain are heel bone fractures, fat pad atrophy (a condition where a layer of fat present under the heel bone is reduced) and bursitis (inflammation of the fluid filled sacs present around the joints). Peripheral neuropathy is a condition where damage occurs in the peripheral nerves (that transmits signals between the central nervous system and the rest of the body), this can cause pain in the heel. 

Symptoms 

The symptoms of heel pain include: 

1. Experiencing pain while jogging or walking 
2. A feeling of pins pricking the heels after waking up in the morning 
3. Inability to put weight on the heel 
4. Painful swelling 
5. Pain in the heel accompanied by fever 

Heel pain can be prevented by taking certain preventive measures such as restricting usage of high heeled shoes without proper support and stretching the heel regularly. Medications such as painkillers are used to treat symptoms of heel pain. Consult a doctor for accurate medicines !!

Menopause is a natural change in a female body that occurs after or around the age of 45, when the ability to bear children stops permanently. The fertility diminishes and the menstrual cycle stops. A decrease in hormone production, especially in the levels of estrogen, happens after the onset of menopausal years.

During this time, there are a number of physical changes that take place inside the woman’s body. The noticeable changes happen in the female breasts.

Some visible changes to breasts during menopause

1. Non-cyclical breast pain is mostly not related to menstrual cycle and slowly stops with time.

2. Loss of glandular tissues is common and causes shrinkage in size.

3. With age, the connective tissues also lose elasticity and causes sagging

4. Breast pain could also be due to fibrocystic breast changes

5. There could be a chance of developing breast cancer

6. Density of the glands decreases inside the breasts and fat develops.

It is advisable to get any kind of discomfort examined by the doctor to make sure you are in the safe zone. Hormone replacement therapy (HRT) is not generally advised as it may create hormonal issues in the long run.

It is also important to follow a healthy diet comprising of protein, calcium , magnesium and other vital nutrients as advised by your doctor. Reduction in smoking and alcohol intake is highly beneficial and cuts down risk of major diseases. It is also necessary to exercise, remain physically active and maintain a healthy body weight during this time.

Regular check-ups, mammograms and self-examination of breasts help to diagnose and detect early signs of breast tumours and cancer and are highly recommended, especially for women who are in the perimenopausal and menopausal years. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

ये सच है की मौत बहाने से आती है और उन बहानों में सबसे आम बहाना होता है बीमारी। हम सभी को जीवन एक बार मिलता है, जिसे हम बेहतर और लम्बा बनाने के लिए हर मुमकिन कोशिश किया करते हैं पर जीवन और मौत के दरम्यान बीमारी की तलवार हमेशा लटकती रहती है। इसलिए हम हमेशा बिमारियों से रूबरू होकर उनसे बचने या जीत हासिल करने की फ़िराक में रहते हैं जिससे अपनी उम्र और स्थिति में इजाफा कर लेते हैं। लेकिन इस बात पर गौर करना होगा कि कुछ बीमारियों से जूझ कर भी हम जीने की उम्मीद नहीं खोते पर कुछ बीमारियाँ ऐसी भी हैं जो हमें मारें उसके पहले ही हम दिमागी तौर पर दिन ब दिन मरने लगते हैं। और आज हम जानेंगे ऐसी ही एक भयावह बीमारी एड्स के बारे में। 

AIDS एक बेहद खतरनाक और जानलेवा बीमारी के रूप में जाना जाता है। यह बीमारी अगर किसी इंसान को हो जाये तो उसकी म्रत्यु निश्चित हो जाती है। केवल भारत को लिया जाए तो सालाना तकरीबन 80,000 से ज्यादा लोगो की म्रत्यु AIDS के वजह से होती है। इसलिए इससे बचना है तो यह जानना बेहद जरूरी हो जाता है कि एड्स क्या है और होता कैसे है ?

क्या है एड्स 
एड्स यानि कि उपार्जित प्रतिरक्षा नाशक रोग समूह, जिसका अर्थ है कि एड्स मनुष्य जाति मेंस्वाभाविक रूप से शुरू नहीं हुआ बल्कि मनुष्य जाति के अपने ही कुछ कर्मों के कारण उपार्जित हुआ। यह एक संक्रामक रोग है जो कि एच.आई.वी. (ह्यूमनइम्यूनो डेफिशियेन्सी वायरस) नाम के विषाणु के संक्रमण की वजह से होता है। जब यह विषाणु शरीर में प्रवेश कर जाता है तो ब्लड में पहुंच कर वाइट ब्लड सेल्स मेंमिलकर उसके DNA में पहुंच जाता है जहां वह विभाजित होता है और रक्त के सफेद कणों पर आक्रमण करता है। धीरे-धीरे यह सफेद कणों की संख्या बहुत कम करदेता है। उसी कमी या समाप्ति के साथ शरीर की रोगों से लड़ने की प्रतिरोधक क्षमता को समाप्त करता है। 

यह विषाणुशरीर में प्रवेश करने के बाद समाप्त नहीं होता। और इसी स्थिति को एड्स कहा जाता है।

• शोधकर्ताओं के अनुसार AIDS दो वायरस के कारण होता है, HIV1 और HIV2।
• HIV1 वायरस दुनिया भर में सबसे ज्यादा पाया जाने वाला वायरस है और HIV2 वायरस ज्यादातर वेस्ट अफ्रीका में पाया जाता है।
• यह दोनों वायरस रेट्रोवायरस नामक प्रजाति के हैं जो अपना DNA इंसान के DNA से मिला देते है, और जिंदगी भर उस इंसान के DNA  के साथ रहते हैं।
• वैज्ञानिकों का कहना है कि मानव शरीर मे पाया जाने वाला वायरस मनुष्यों में बंदरों की प्रजातियों से आया है क्योंकि बंदरों में पाए जाने वाले HIV वायरस और मानव शरीर मे पाए जाने वाले HIV वायरस में काफी समान्यताएँ है।
• 1930 से 1940 के बीच पहली बार इंसानों में यह वायरस मिला। जो माना जाता है कि बंदर का मास खाने वाले कुछ अफ्रीकी आदिवासियों में पाया गया था और पूरी दुनिया में  फैल गया।
• भारत देश AIDS के मरीजों की संख्या के मामले में दुनिया का तीसरा सबसे बड़ा देश है।

यह जानना जरूरी है की HIV छूने से नहीं फैलता। यह केवल शरीर के अंदर मौजूद तरल पदार्थ जैसे थूक, खून, और सेक्स के द्वारा निकलने वाला सेमेन से फैलता है। क्योंकि HIV वायरस शरीर के बाहर जीवित नहीं रह सकता तो 

HIV  के संक्रमण के कारण 

1. वजाइनल, ऐनल और ओरल सेक्स
एचआईवी/एड्स से ग्रसित व्यक्ति के साथ असुरक्षित सेक्स करने से इसके वायरस आपके शरीर मे आ जाते हैं। यह वायरस किसी के शरीर मे चुम्बन द्वारा भी आ सकता है पर इसकी संभावना कम होती है क्योंकि थूक में HIV का वायरस कमज़ोर होता है। और चुंबन  करते समय कम से कम 1-2 लीटर थूक एक्सचेंज हो एक दूसरे का तभी संभव है ठुक द्वारा  HIV/AIDS होना।

2. माँ द्वारा 
यदि जन्म देते समय माँ में HIV वायरस मौजूद है तो वह वायरस बच्चे के अंदर आ सकता है। यदि जन्म देने के बाद किसी कारण से माँ के अंदर HIV का वायरस आ जाता है तो यह बच्चे में स्तनपान के द्वारा भी आ सकता है। सही समय पर सही कदम लेने से यह रोका जा सकता है। सही कदम नहीं उठाने के कारण तकरीबन 30% बच्चे जन्म से ही HIV/AIDS से संक्रमित होते हैं।

3. इंजेक्शन
किसी HIV/AIDS के मरीज़ के शरीर मे इस्तेमाल की गई सुई को किसी दूसरे व्यक्ति के शरीर मे इस्तेमाल करने से HIV/AIDS फैल सकता है। 

4. शल्य चिकित्सा शास्त्र
शल्य चिकित्सा शास्त्र यानी सर्गिकल इंस्ट्रूमेंट्स जो सर्जरी करने के लिए इस्तेमाल की जाती है अगर HIV AIDS के मरीज़ के शरीर पर इस्तेमाल की गई हो और उसे बिना अच्छे से साफ किये दूसरे के शरीर मे इस्तेमाल किया जाए तो HIV AIDS फैल सकता है। 

5. संक्रमित रक्त 
HIV/AIDS एड्स से ग्रसित व्यक्ति का खून बिना जाँच किए किसी को चढ़ा दिया जाए तो उससे भी HIV/AIDS हो सकता है।

6. म्यूकस मेम्ब्रेन
म्यूकस मेम्ब्रेन जो शरीर के आन्तरिक अंगों को घेरे रहती है और सभी कैविटीज की सबसे ऊपरी परत होती है यदि उसमें HIV/AIDS का संक्रमित रक्त लग जाता है तो उस व्यक्ति को  HIV/AIDS हो सकता है। जैसे कि यदि किसी को चोट लगी हो और उस चोट पर किसी व्यक्ति का खून लग जाए जिसे HIV /AIDS हो तो उस खून में मौजूद HIV वायरस उस चोट लगे हुए हिस्से से दूसरे व्यक्ति के शरीर मे प्रवेश कर जाता है।

बताये गए कारणों से HIV /AIDS फैलता जरूर है पर जरूरी नहीं है कि इन वजहों से किसी का खून यकीनन संक्रमित ही हो जाए। यह इसपर भी निर्भर करता है कि HIV वायरस कितना मजबूत है। यदि कमज़ोर HIV वायरस किसी के शरीर मे किसी भी तरीके से चला जाए तो संभव है कि उस व्यक्ति को HIV/AIDS न हो।

बदकिस्मती से दुनिया मे HIV को लेके कई गलतफैमियाँ है इस कारण यह भी जानना जरूरी हो जाता है कि HIV AIDS किन कारणों से नही फैलता।

• कीड़े मकोड़ो के काटने से 
• किसी HIV AIDS के मरीज के मूत्र और पसीने से
• शौचालय या स्विमिंग पूल कोन से करने से 
• HIV AIDS के मरीज का टॉवल या कपड़ा इस्तेमाल करने से 
•  HIV AIDS के मरीज़ों को छूने से या साथ काम करने से 
•  HIV AIDS के मरीज के साथ एक थाली में खाने 
•  HIV AIDS के मरीज का किसी के सामने छींकने से या खाँसने से भी HIV AIDS नही फैलता।