Navjivan Hospital

A Jet Airways aircraft Boeing 737, travelling from Mumbai to Jaipur with 166 passengers on board, had to return to the airport as the crew forgot to turn on the cabin pressurisation system which maintains air pressure inside an aircraft to a comfortable level.

The mistake led to several passengers suffering from nosebleed, bleeding from ear and severe headache. Some of the passengers were even admitted to the hospital with these complaints.

What does Air Pressure mean?

Air pressure, also known as Barometric pressure or atmospheric pressure, is the weight of the atmosphere pressing down on earth. It is measured by a barometer in units called millibars. The standard or average atmospheric pressure at sea level on the earth is 1013.25 millibars per square inch, which is about 14.7 pounds.

What are the causes of Air Pressure?

Air pressure is caused due to air molecules present in the atmosphere. The higher the altitude, the lower is the air pressure, which makes it tough for humans to survive without proper equipment.

The aircrafts use cabin pressure by pumping in ‘bleed air’ to maintain barometric pressure. This pressurisation becomes highly necessary when the aircraft touches altitude above 10,000 feet (3,000 meters) from sea level.

What health issues do low Air Pressure cause?

Low air pressure can cause mild as well as death threatening conditions which include:

Blood pressure: As the air pressure reduces, the blood pressure also starts falling. It can be observed if you are feeling dizziness or a blurred vision.

Severe headache: Change in barometric pressure can lead to severe headache or migraines by creating a pressure difference between the atmosphere and air-filled sinuses.

Joint pain: As per a study, the change in barometric pressure increases the severity of joint pain and arthritis.

Blood sugar: Change in air pressure bring cold fronts , which is not good for a diabetic person.

Hypoxia: The lower oxygen pressure reduces the oxygen tension in the lungs, subsequently in the brain. This can lead to dimmed vision, sluggish thinking, loss of consciousness and eventually death.

Altitude sickness: In the most common response to hypoxia, the human body starts hyperventilation. It does help in partially restoring oxygen in the blood but it also leads to carbon dioxide to out-gas which increases the blood pH level. In this condition, people may suffer fatigue, nausea, headache, sleeplessness and even pulmonary oedema.

Decompression sickness: It leads to tiredness, forgetfulness, headache, stroke, thrombosis and subcutaneous itching.

Barotrauma: As the aircraft climbs or descends, passengers may face discomfort or acute pain as gases trapped inside their bodies try to expand. The most common problems faced due to this situation include air trapped in the middle ear or paranasal sinuses by a blocked Eustachian tube. It can also cause pain in gastrointestinal tract or even the teeth.

What emergency steps should be taken in situation of low air pressure?

The effects of low air pressure may vary from person to person. Some people do not feel any health problems even while being at an altitude as high as 8,000 feet while some would start feeling restless from 5,000 feet onwards.

There may be many precautions including carrying an oxygen cylinder always while travelling to the high altitude places. In aircrafts, oxygen masks are provided to each passenger but if you are planning to go on a trek, you must know some important aspects of surviving at high altitude places. Have a look:

• Avoid smoking and alcohol consumption
• Avoid switching on the heater
• Take proper sleep at night with a pillow under your head
• Keep yourself hydrated and do not over-hydrate
• Do not overeat
• Never exert yourself

Emergency tips to keep yourself safe at high altitude places:

• Ginger or ginger water
• Garlic
• Clove
• Lavender oil

These things can help you keep your mind and body fit even at the reasonably high altitude places.

The bladder is a muscular sac that is seated just above the pubic bone. The organ stores urine produced by the kidneys allows us the control the frequency of urination by the expansion and contraction of its muscles.

Pain in the bladder is usually caused due to one of three reasons:

1. Interstitial cystitis: This is a chronic condition which affects more women than men. It makes the bladder inflamed and irritated. The bladder walls turn stiff because of this which makes it difficult for the bladder to expand. Interstitial cystitis may be caused by a defect in the lining of the bladder.
2. Urinary tract infection: Urinary tract infections can affect a person at any age and may develop in the ureter, urethra, bladder or kidneys. However, it is most commonly seen in the bladder. This infection is caused by bacteria that enter the body through the urinary tract.
3. Bladder cancer: Cancer that develops in the bladder is known as bladder cancer. Transitional cell carcinoma is the most common type of bladder cancer cell. This begins in the innermost layer of the bladder lining. Pain during urination and discomfort in the lower pelvic region are common symptoms of this disease. Once the cause is diagnosed, antibiotic medication can help treat bladder pain.

Along with that, there are a few things you could do at home as well-

1. Drink plenty of fluids: Ideally, we should drink 8-10 glasses of water a day. Water keeps the body hydrated and helps flush toxins from the body. It also helps dilute the urine. This can make urination less painful as concentrated urine may be acidic and difficult to pass. Water also helps prevent the formation of kidney stones and thus helps the kidneys function optimally.
2. Urinate frequently: Do not try to control your urine. Holding urine in for extended periods of time allows bacteria to multiply within the body. It is also important to urinate after intercourse as sexual activities can push the bacteria present on the skin deeper into your body. This is important for both men and women.
3. Dress comfortably: Avoid synthetic, tight fitting underwear and clothes. Instead wear, loose, comfortable clothes that are preferably made out of cotton. These clothes will help keep your skin dry and not allow bacteria to breed.
4. Pain relievers and heating pads: Sometimes, antibiotics can take a day or two before addressing bladder pain. In such cases, pain relievers can help deal with the discomfort and cramps. Heating pads can also help soothe abdominal and lower back pain that results from bladder infections.
5. Diet: It is recommended that alcohol tomatoes chocolates caffeinated beverages may contribute to bladder irritation and inflammation BB.
6. Smoking: Smoking makes the bladder symptoms worse therefore should be avoided. 
7. Certain stretching exercises: This also help to relieve PBS symptoms Drug therapy also used for this but takes around 6 months to relieve symptoms.

Polycystic ovarian disease or PCOD is a disease of the ovary that is characterized by the larger size of the ovary, fluid-filled sacs in the ovary, multiple cysts etc. In this condition, the ovary is covered by a white, tough, and thick outer covering. PCOD can have many implications including hormonal imbalance, menstruation cycle related disorders, insulin production and its usage etc. Ayurveda explains PCOD as a Kapha disorder and aims at clearing the obstruction of Vatadosha of the pelvis, normalize the menstrual cycle and balance metabolism.

Causes of PCOS
As per modern science the cause of PCOS is not fully understood. It is unknown.

1. Hereditary – Genetics may be a factor. PCOS seems to run in families, so your chance of having it is higher if other women in your family have it or have irregular periods or diabetes. PCOS can be passed down from either your mother's or father's side.
2. Hormonal imbalance – In PCOS there is abnormality in secretion of androgens, luteinizing hormone(LH), sex hormone-binding globulin (SHBG), prolactin. This may cause you to stop ovulating.
3. Insulin resistance- Your body may have problems in using insulin leading to abnormal blood sugar levels. This increases the levels of insulin in your body, which increases androgen secretion again leading to hormonal fluctuations. The exact reason why these hormonal changes occur isn't known.
4. Mild inflammation- Women with PCOS have mild inflammation, this type of low-grade inflammation stimulates polycystic ovaries to produce androgens in the body.

Ayurvedic approach in treating PCOD

Ayurveda looks at a holistic approach of treatment wherein the mind and the body are treated as one. The first step towards treating PCOS disorder is to reduce body weight along with lifestyle modification. The next step aims at countering the condition of PCOD with Panchakarma - a century-old treatment mechanism of Ayurveda. Some of the Panchakarma methods used in treating PCOD include Vamana, Vasthi, Virechana, Nasya etc. Before applying the Panchakarma therapy, oral administration of medicated oil is necessary. PCOS is a complex disorder which falls in artava kshaya, anartava, rasa vaha sroto dushti and medo vaha sroto dushti.

There is a definite cure for PCOS in ayurveda. But you must be patiently strong and willing as treatment may extend upto 6 months or 1 year.

Treatment includes panchakarma and internal medication. Panchakarma procedures like udvartana, vamana, virechana and basti.

1. Uthara Vasthi: This procedure is very different from normal Vasthi in terms of its administration, ingredients, and quantity. This medication is applied to the uterus through the vagina. This is one of the best therapy when it comes to treating the polycystic ovarian syndrome.
2. Vamana: Suitable herbal medication is prescribed to induce oral vomiting. It ensures that the toxin from inside the body comes out before the medication takes its effect on the source.
3. Virechana: This is one of the cleansing methods that is prescribed in Panchakarma therapy. A patient is given herbal purgatives in the form of medicated oil to clear blockages of the Vata Dosha.
4. Basti: This is the form of Panchakarma therapy that is meant for cleaning the alimentary canal. It has a calming effect on the Vata aggravation. This is the mode of medication where medicated herbal oil is injected through the anus. This procedure in Ayurveda is known as Basti. This is followed by another round of oil medication that has a mixture of herbal decoction, medicated oil, herbal paste, rock salt etc. 

​Benefits of Panchakarma in Women with PCOS

1. Reduces body weight.
2. Decreases insulin resistance.
3. Regulates normal hormone secretion. Fine tunes the endocrine system.
4. Remove toxins.
5. Corrects body metabolism.
6. Mental faculties, strength and vitality are enhanced.
7. Promotes fertility.

What is anorgasmia?
The reduced ability to orgasm or the inability to orgasm post sufficient stimulation is called anorgasmia. This disorder is quite common in women. In fact, most women cannot orgasm with vaginal stimulation alone. Some require clitoral stimulation by rubbing or oral sex.

What are the types of anorgasmia?

1. Generalized anorgasmia: Orgasms are not achieved with any partner, be it in any situation
2. Lifelong anorgasmia: No orgasms have ever been felt
3. Acquired anorgasmia: You have climaxed before but due to certain factors, be it emotional or physical, you have stopped getting orgasms
4. Situational anorgasmia: Here you may have been able to orgasm before but only in certain positions or a particular partner.

What may cause anorgasmia?
Orgasms can be complex things. It involves the combination of physical, emotional and psychological factors. Anorgasmia can occur if any of the above is affected.

Physical causes

1. Medical illnesses: Diseases such as diabetes or multiple sclerosis can result in anorgasmia.
2. Medications: Medicines, for example, antidepressants, anti- histamines, cardio-vascular agents can meddle with climaxes.
3. Smoking and Alcohol: Excessive alcohol consumption can mess with the ability to peak; smoking constraints the blood vessels, thus having a similar impact on both the sexes.
4. Gynaecologic issues: Surgeries such as hysterectomy or surgeries of carcinoma can hamper with the capacity to accomplish climaxes.

Mental Causes:

1. Poor self-perception
2. Embarrassment
3. Anxiety or dejection
4. Financial issues and stress
5. Fear of Sexually Transmitted Diseases or pregnancy
6. Past passionate or sexual mishandle

Relationship issues

1. Fights or clashes in the relationship
2. No fascination toward the partner
3. Lack of association
4. Infidelity
5. Poor association with partner in regards to sexual needs

What are the symptoms of anorgasmia?
The symptom of anorgasmia is the inability to achieve orgasms in spite of sufficient sexual stimulation. It could be because of your partner or because of the position that does not really hit your spot.

A biliopancreatic diversion with duodenal switch is a less common kind of weight-loss procedure. The procedure is conducted in two steps. The first step involves sleeve gastrectomy, where about 80 percent of the stomach gets removed, hence leaving behind a small stomach, in the shape of a tube. Though the valve, which releases food to the small intestine remains intact along with a small portion of the small intestine that normally stays connected to the stomach. The second step ensures that the major part of the intestine gets bypassed through connecting the end portion of the intestine to the duodenum close to the stomach. A Biliopancreatic Diversion (BPD) puts a limit on how much one can eat and thus reduces the nutrients from getting absorbed, which includes fats and proteins.

BPD is usually conducted as a single procedure but in some selective situations, the procedure might get performed as two separate operations, sleeve gastrectomy and that is followed by intestinal bypass once the process of losing weight has begun.

Why the surgery is conducted?
A Duodenal Switch with Biliopancreatic Diversion is done in order to assist a person in losing excess weight and thus reduce the risk of developing potential life-threatening health problems related to health, which includes:

• High blood pressure
• Heart disease
• High level of cholesterol
• Severe kind of sleep apnea
• Type 2 Diabetes
• Infertility
• Stroke

Eligible candidates for the surgery

• This surgery is mostly done only when people have tried to lose weight by making improvements in their diet and exercise habits.
• Still, this surgery is not for every individual who is overweight. People would have to go through an extensive process of screening to determine if they qualify.
• Patients, who become eligible, have to be willing to make permanent changes so as to lead a healthy lifestyle both before as well as after the surgery.
• This might include long-term plans where they follow-up by monitoring if they are maintaining their nutrition, lifestyle, behaviour and also their medical conditions.

Risks associated with the surgery
This particular surgery, as with any other surgery, carries some potential risks. They are both in the short-term and in the long-term.

Risks associated with BPD/DS are similar to any abdominal surgery and include:

• Excess amount of bleeding
• Infection
• Adverse reactions to anesthesia
• Blood clots
• Shortness of breath due to breathing problems
• Leaks might arise in the gastrointestinal system.
• Long-term risks and complications from this surgery might include:
• Obstruction in the bowel movements
• Dummping syndrome leading to diarrhoea, nausea and vomiting tendencies.
• Gallbladder stones
• Hernias might arise
• Blood sugar level might come down
• People might even suffer from malnutrition
• There could be perforation in the stomach

Dilation and curettage is a surgical procedure where the cervix (the lower part of uterus) is dilated and tissues are removed from the inside of the uterus. The procedure is usually done to treat heavy menstrual bleeding or clean the lining of the uterus after an abortion or miscarriage.

During the procedure, the cervix is dilated with medication and a thin surgical instrument is inserted through the vagina. This instrument is then used to scrape (curettage) the uterine tissues.

Reasons for Conducting the Procedure

Dilation and curettage is mostly done to either treat or diagnose certain uterine disorders. Dilation and curettage is recommended if your doctor needs to diagnose conditions such as:

1. Irregular uterine bleeding

2. Postmenopausal bleeding

3. Discovery of unnatural endometrial cells while conducting a common test for cervical cancer

Sometimes, the doctor can take a sample tissue from the uterus and perform tests on it to check for the following conditions:

1. Uterine cancer

2. Uterine polyps (abnormal tissue growth)

3. Endometrial hyperplasia (precancerous thickening of the uterine lining)

Dilation and curettage, when used for therapeutic purposes, is used in the treatment of the following conditions:

1. To clear away molar pregnancy; which is characterized by formation of tumours.

2. To treat heavy bleeding after childbirth; any remaining placenta in the uterus is removed.

3. To remove benign uterine or cervical polyps.

4. To clear away fibroids (benign tumours which form on the uterine wall)

5. To remove any tissue that could have been left behind after an abortion or miscarriage to prevent heavy bleeding or infection

What needs to be considered before opting for it?

The procedure of dilation and curettage is mostly safe. Complications from this procedure are rare, but some factors should always be taken care off.

1. The surgical instrument can perforate or poke a hole in the uterus. Sometimes, perforations can heal on their own; but if any organ or blood vessel gets damaged, then another surgery will be required.

2. The cervix can be damaged during the procedure. The doctor can stitch the wound close, or apply pressure on the wound to stop the bleeding.

3. Sometimes, there might be scar tissues on the wall of the uterus. This can cause irregular, painful or absent menstrual cycles, augment risks of infertility and future miscarriages.

If there is blood in your urine, it is a sign of renal illness. While this could be happening because of various reasons, it is advisable to see your doctor soon.

Following are the causes of blood in your urine:

1. An enlarged prostate - An enlarged prostate is a common cause of the appearance of blood in the urine in men who are in their middle ages or older. Enlargement of the prostate gland causes the urethra to be compressed. This prevents the urethra from getting fully emptied while urination.
2. Cancer - A cancerous kidney, bladder or prostate gland can also cause blood to appear in the urine. It is another major cause of hematuria but usually occurs in older patients.
3. Infection - Infections like urethritis, pyelonephritis, cystitis or infection in any other body organ along the urinary tract is one of the most common causes of hematuria. Such bacterial infection in the urethra can also infect the kidneys and the urinary bladder. It results in the urge to urinate frequently and also causes blood to appear in the urine.
4. Kidney stones and bladder stones - Another reason that can cause blood to appear in the urine is the presence of stones in the kidney or bladder. These stones are crystallized minerals that are formed in the kidney or the bladder but fail to pass through the urinary tract. They cause blockage and pain and result in hematuria.
5. Polycystic kidney disease - PKD is a kidney disorder in which cysts filled with fluid form in the kidneys and impair the kidneys, causing them to fail entirely at times. It is an inherited disease and causes blood to appear in the urine.In children who are between 6-10 years of age, kidney disorder after streptococcal glomerulonephritis can be a possible cause of hematuria.

While pregnancy is not a pathological condition, it is a happy time that can be marred by various conditions. Debilitating morning or all day sickness, which is usually characterised by nausea, reflux in the gastro esophageal band, heartburn and acidity. This can also turn into vomiting and lead to complications if it does not stop. Persistent, almost daily vomiting can be termed as excessive vomiting in pregnancy, and this is known as Hyperemesis Gravidarum in medical terms.

Let us find out more about this condition.

Routine: Hyperemesis Gravidarum usually strikes as a matter of routine at a set time everyday where the patient will either be in unappetising company of acute and painful acidity and nausea, or will also be vomiting.

Severity: The severity of the condition usually decreases as the patient's pregnancy progresses. Usually, this condition strikes around the fourth or fifth week of pregnancy, before becoming better towards the middle of the second trimester. There are cases, though, where it continues to be just as severe till the very end of the pregnancy.

When to take Action: The patient may have to be hospitalised in case too much vomiting takes place, so as to prevent excess loss of water and salt from the body, and resultant weakness which may affect the growth of the foetus. Also, it is best to call the doctor when you have experienced fainting and dizzy spells.

Causes:

Hyperemesis Gravidarum or excessive vomiting during pregnancy cannot be attributed to any specific or single cause. Usually, it is known to be a genetic condition passed down by mothers to their daughters. But in most cases, doctors believe that the condition is due to hormonal changes where an increase in the HCG hormone, or Human Chronic Gonadotropin hormone level during pregnancy may lead to a variety of symptoms such as morning sickness or excessive vomiting. This hormone is known to be at its peak during pregnancy.

Risk Factors: It has mostly been seen that women who are carrying twins are at risk of suffering from this condition. Also, women who have suffered from chronic motion sickness in the past report excessive vomiting during pregnancy.

Treatment: The best way to treat this issue is to prevent too much of nausea and vomiting with the help of a bland diet that does not have heavy to digest ingredients. Also, it is best to take small and frequent meals.

Working your way around excessive vomiting during pregnancy is a matter of ensuring that you take rest, fluids and other precautions. Speak with us in a private consultation to know more.

The disruption of the normal female cycles of menstruation and ovulation after the age of 45 and the loss of her ability to conceive naturally is known as menopause. The associated symptoms of menopause are heat flushes, insomnia, weight gain, depression, nausea and fatigue. While hormone replacement therapy is the most common procedure to provide relief from menopausal symptoms, natural homeopathic remedies can also be used for the same. These remedies are completely safe as opposed to hormone replacement therapy which has a number of side effects. The following homeopathic medicines and remedies can be used to treat menopause:

1.        A balanced diet which provides you with optimal nutrition can be helpful in treating menopausal symptoms. When you get enough vitamins and minerals, the physical discomfort caused by the symptoms can be reduced greatly.

2.        Phosphorus can help with migraines, extreme sweating, numb hands, fast pulse, memory problems and dry and itchy skin. Foods high in phosphorus content are meat, fish, cheese, nuts and seeds of pumpkins, sunflowers etc.

3.        Excessive deposition of fat can interfere with the hormonal cycles and cause imbalances in the level of estrogen and progesterone. So, regular yoga and exercise can be helpful.

4.        Amylenum nitrosum can provide relief from profuse sweating, shortness of breath and palpitations.

5.        Phytoestrogen or dietary estrogen is a compound found in foods such as soybeans, oats, barley, carrots, fenugreek, rice etc. Phytoestrogen can provide natural relief from menopausal symptoms.

6.        Aurum metallicum is used to get the tissues and organs to function normally again and control feelings of anxiety and claustrophobia.

7.        Aconitum napellus (wolf's bane) is a flowering plant and its extracts can reduce panic attacks, heat flushes, over excitability and depressive symptoms.

8.        Argentum nitricum is a nitrate compound of silver which is used to control excessive bleeding in the pre-menstrual stages.

9.        Belladonna (deadly nightshade) is beneficial for a large number of symptoms such as headaches, fatigue, insomnia, frequent urination, osteoporosis, abnormal weight gain and other nervous disorders.

10.        Bryonia alba, a flowering plant, is used as a remedy for vaginal infections, rashes and vaginal dryness that are common during menopause.

11.        Natrum muriaticum, in small amounts, helps to reduce stress. Stress can cause problems in thyroid function, cognitive functioning, digestive system functioning and it can elevate blood pressure levels rapidly.

12.        Nux vomica (strychnine) is a common homeopathic medicine for nausea, vomiting and indigestion. These problems are seen frequently in menopausal women, especially after meals at night.

PMS is often treated as a joke but for many women, it is a monthly nightmare. Muscle cramps, headaches, bloating, breast tenderness, anxiety and depression are common symptoms of PMS. Though there is no set cure for PMS here are a few tips that will help you deal with it.

Set yourself an exercise routine

Exercising not only helps you maintain weight but also helps dealing with PMS. All you need are 30 minutes a day set aside to go for a brisk walk, jog, swim or even dance. Aerobic exercises like this improve blood circulation, ease stress and help the brain release more happy hormones.

Change your diet

If you are feeling bloated and depressed, cut back on simple carbohydrates like sugar and fat and increase your consumption of complex carbohydrates like fruits, vegetables and whole grains. Do not attempt a low carb diet to lose weight if you suffer from PMS. Reducing the simple carbohydrates in the body and increasing the complex carbohydrates keeps you body feeling full for longer and increases the serotonin levels in the body.

Quit alcohol and caffeine

Drinking a glass of wine of a cup of coffee may give you temporary relief from PMS symptoms but in the long run they aggravate your PMS symptoms such as headaches, breast tenderness and mood swings. Alcohol may also contribute towards lowering the magnesium levels in your body and thereby make you feel bloated.

Relax

One of the effects of PMs is to make you feel anxious and tense. The easiest way to address this is by learning to relax. Try meditation or yoga for half an hour every morning. This will improve your overall health as well as soothe muscle pains.

Take a few supplements
 

Research says that certain fatty acids like omega 3 and linoleic acid can lower irritability and body aches associated with PMS. Calcium is also known to help ease PMS symptoms. Getting these nutrients in the required levels may not be possible only through your daily meals. Hence, you can also consider supplements to ease your pains.

Use Birth control pills

Birth control pills with the drospirenone hormone can help ease symptoms of severe PMS. Menstruation is often accompanied by a drop in estrogen levels that can lead to migraines. Regular of birth control pills also regulates your hormones and hence avoids these fluctuations. It also keeps your ovaries from releasing eggs every month and hence reduces the intensity of the associated cramps.

Talk to people

You are not alone when it comes to PMS. Instead of keeping quiet about your discomfort, talk to people who may be experiencing something similar. Sharing your problems will introduce you to new ways of dealing with it. You could also get online support though various discussion groups.