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Showing posts from 2016

Say Cheers to Water

While we could debate on whether the old health-tip of drinking at least 8 glasses of water a day is indeed valid, water has interestingly retained its top position as the most popular health drink in the world. Over 60% of the human body is composed of water. Water assumes the status of a nutrient for carrying out many of vital functions. Apart from replacing the amount lost each day through sweating, respiration, urine and stools, water forms the medium for all our digestive juices, brain fluids, blood and enzymes. When water intake does not match our output, the body becomes dehydrated. Urine becomes scanty and dark, tongue becomes dry, eyes sunken, the pulse thready and blood pressure low. Thirst is the body’s way of signalling that we need more water. If not replenished, weakness and failure of organs can follow, sometimes leading to death. The amount of water we need to drink depends on several factors. People working outdoors in hot dry weather conditions may need to dr

How Doctors Die

Unlike the perception of most relatives that doctors treat critical patients callously, they in fact often “over-do” than what may be reasonable. Says a intensivist “Rescusciation or CPR (cardio-pulmonary resuscitation) looks nothing like what we see on TV. In real life, ribs often break and few survive the ordeal. "I felt like I was beating up people at the end of their life. I would be doing the CPR with tears coming down sometimes, and saying, 'I'm sorry, I'm sorry, goodbye.' Because I knew that it very likely wa not going to be successful. It just seemed a terrible way to end someone's life." Doctors fall ill and die just as others in society do. Interestingly in spite of all their knowledge about the body, its ailments and cures, they life expectancy is not much different than the general population. What is indeed different is what they choose to go through themselves compared to what they do to others. In a revealing article “How Doctors C

Natural Ways to Get Sleep

It is funny that while sleep is a natural state of relaxation in which we spend one third of our daily lives or a third of our total life years, many of us seem to struggle to get it. Sleep, in contrast to wakefulness, is a condition when our conscious mind switches off leaving the stage to the unconscious mind that often reveals itself in the form of dreams. Healthy sleep in adequate amounts is essential for our brains, minds and bodies. Popping a sleeping pill has become an easy way out. At the last count there are over a hundred types of sleeping pills available for treating ‘insomnia’, the medical term for lack of sleep, with 3 of every 20 Indians consuming them. Most medications however provide an abnormal drugged form of sleep, create dependence or have adverse effects. Getting enough of the natural sleep and at the appropriate time therefore continues to be a challenge. The commonest form of sleep disorder especially in young people is difficulty in falling asleep.

GM Diet for Weight Loss

In recent times, my growing paunch has become an embarrassment especially when I counsel my obese patients about shedding fat. Hence I have been exploring an easy quick way that would be compatible with my lazy nature, to get back to shape. I came to know about the GM diet that several people I have now met seem to have tried and found useful. Further it comes with a vegetarian adaptation that can suit most Indians. I understand that it has become the most popular weight losing diet in the country. The GM diet is named after General Motors company of the USA where it was first developed to help obese employees shed weight, get back a healthy glow and feel energised. It was tested and endorsed by the reputed Johns Hopkins Research Centre. It is based on a principle of rotating foods on a day to day basis and drinking lots of water to detoxify the body. Its biggest advantage is that it does not make you starve as many diets do. The expected weight loss is between 2 to 5 Kg in 7

Medical Strangulation

Gunja, a 31 years old pretty vivacious woman who works as a medical administrator in a corporate hospital and stays alone in an apartment, is perpetually frightened ever since she survived a near death experience from suffocation a year ago. Over the last two years, every now and then she suddenly breaks out into angry itchy hives all over her body, along with a feeling of choking that makes her gasp for breath. She recounts in horror when she had a particularly bad attack one early morning while she was alone at home. Soon after the skin hives started appearing, she experienced a feeling as though someone was tightening a noose around her throat. She gradually turned blue and lost consciousness. Luckily, she had been able to pick up her cellphone and make a call to her doctor-friend who, sensing something seriously wrong had rushed to her home and injected her with adrenaline, which had saved her in the nick of time. Subsequent tests showed that she suffered from a rare con

Try Fasting to Get in Shape

While loosing weight can indeed be a formidable challenge for those suffering from obesity, my experience suggests that most do not really try hard enough to get back to shape! They go through the customary dietary consults and sermons on regular exercise, give the appearance of being convinced and motivated, but turn up after a couple of months without having shed any weight. Sometimes, their weight paradoxically go up after they start going to the gym. Many manage to get off fats, but increase their consumption of starch and sugars. It is true that one gram of butter or oil provides 9 Kcal while sugars and starch provide only 4 Kcal, but snacking on potato chips or drinking fruit juices can add more to your belly than a thin smear of butter on a brown toast. On trying to unravel the mystery of why some gain weight after starting workouts instead of losing it, many admit to increasing their food intake in response to hunger that exercise drives up. What seems to lie at the ro

Uberification of Health Care

The imaginative concept of matching transportation demands of people with cab facilities using a smartphone platform that Uber is credited to having created is now beginning to be applied to health care as well. At the outset, let me share with you what I understand of Uber. It is an on-line transportation company that develops, markets and operates the Uber mobile app, which allows consumers with smartphones to connect with Uber drivers through a software platform for taxi service. Uber itself does not own any assets such as cars, or hire the drivers. Uber was founded by Tavis Kalanick and Garrett Camp as recently as 2009 in San Francisco, but the impact and success of this “start up” has reverberated across the world, being now valued at US $ 62.5 billion. Fresh successful ideas in one domain often tickle the minds of entrepreneurs in other fields. Healthcare experts are now trying to explore if they can bring about a revolution in their sector as well. The proposition se

Plasma therapy for Baldness to Joint Diseases

Excessive hair loss, or alopecia as it is medically called, now has a promising new therapy. Doctors are using platelets from the patient’s own blood to stimulate hair growth. Platelets are small little particles present in blood that play an important role in plugging leaking arteries and in clotting. They also contain a large number of “stimulating factors” that stimulate degenerating tissues to grow again. There are several of them such as platelet derived growth factor (PDGF), growth stimulating factor (GSF), epidermal growth factor (EGF), vascular epidermal growth factor (VEGF) and mediators like Interleukin 8 which stimulate growth of hair follicles and cells of several tissues such as nerve cells, bones, cartilage and muscles. This newly discovered property has suddenly catapulted plasma into centre stage. Plasma rich platelet (PRP) therapy as it is called, involves drawing a sample of autologous (patient’s own) blood, mixing it with an anti-coagulant that prevents it

Good Old Aspirin for Cardiac Emergency

Heart attacks are common above 40, often coming at odd times, without warning, and are the commonest killer of our modern times. The best chances of reducing the severity of an acute attack and improving the chances of survival are by chewing aspirin at the very start and reaching a hospital within 2 hours. A doctor colleague of mine, Dr Anil Behl, has started a unique form of social service, of putting 4 aspirin tablets in a plastic pouch and keeping it available at all times with the security check-post of his housing colony. He has backed up this simple act by informing all residents of his colony by email and posters, that should anyone have early symptom of heart attack, they should immediately procure the pills from the security room and chew them while waiting for further help to arrive. During a heart attack, blood clot forms in the arteries of the heart blocking the flow of oxygen-rich blood to heart muscles. Clot formation begins with clumping of small blood particles ca

Microbial Garden in Your Gut

The paradox that scientists are trying to come to terms with is that our “healthy” human body is loaded with germs, and that these germs might be conferring positive health to our bodies. To be specific, we carry over a trillion (1014) bacteria in our guts. And they belong to as many as 400 different species. If we could scoop them all out and place them on a weighing scale they would weigh as much as 1.5 to 3 Kg, even more than the clothes we wear! The presence of this huge bustling wild-life sanctuary of little animals or microbial garden in our guts has puzzled scientists for decades. There was a time when “germs” were those terrible little things that caused nasty infections and often took lives. In fact, when some of these germs migrate from the gut to “abnormal” places such as the urinary tract, they produce illnesses such as urine infections. The logical approach that scientists therefore took in the last two centuries was to rid the body of all germs, in an attempt to “

Emergency Medical Kit

The regular depiction in TV serials of a doctor arriving home almost instantaneously when summoned on telephone to attend to an emergency, could not be farther from reality. Most good doctors do not attend home calls, and the chances of getting one in the middle of the night when you are down with an attack of incessant vomiting or an allergy could be well neigh impossible. It makes perfect sense to keep some medicines at home or carry on travel. Here are some tips on how to make your own emergency medicine kit: 1. Keep medicines that you are familiar with, and preferably, have taken before, so that it is not a first timer during an emergency and that too in a new place.  If you take a new antibiotic while on travel, and come down with hives, things can get rather complicated. 2. If you are not good with tongue twisting drug names, put them in labelled envelopes according to indications. For example, you could have paracetamol tablets in an envelope labelled “Fever, Body pains

Are we prepared for ZIKA?

I had honestly not heard of ZIKA virus till recently, when this hitherto unheard virus shot into international fame for allegedly damaging the brains of babies growing in their mother’s wombs, and having them being born in vegetative states with mental retardation.  It is true, that ZIKA, which spreads through mosquito bites, does not seem to be dangerously fatal to the humans it stings, but the suspected havoc it causes to expecting mothers, who go on to deliver deformed mentally retarded babies, and the effect of this trauma on their families is often perceived by many to be worse than death. Although ZIKA virus epidemic is raging in distant countries like Brazil, Mexico, Africa and other South American nations, it would be silly to adopt an “ Abhi Dilli Door Hai” stance. The same strain of mosquito that spreads ZIKA, called Aedes aegypti, is rampant in most ‘nukkars’ and ‘galis’ of India. At the moment it is fervently engaged in spreading other viruses such as Dengue and Chi

Plastic Bags are a Health Menace

Plastic carry bags that are so liberally doled out by grocers and store-keepers are emerging a major health hazard and killer. They are made of polythene, a product of petroleum and can be seen littered on roadsides, drains and fields while you travel by car or train. They choke landfills and drains and have even caused floods. They block the intestines of cattle and marine animals when they are ingested mistakenly while grazing, and kill around 10, 00,000 each year by painfully strangulating their intestines or by choking. Disposing these bags is not easy; their burning releases toxins that are harmful to environment and us. Burying them causes the landfills to choke as polythene does not breakdown and decompose easily, and when they do, release toxins into the soil that find their way into the food chain. Sometimes plastic bag litter can cause more problems. According to Nobel Peace Prize winner, Professor Wangari Mathaai, discarded bags fill up with rainwater and become perfe

What does Research say about Happiness?

The secret to happiness may have to do with relatives and friends rather than money and fame, reports a recent scientific study. The findings of a 75 years long study undertaken by Harvard University researchers to find out what makes people happy and healthy as they go through their lives, was presented by Dr Robert Waldinger, the fourth director of the long research project, in his crisp 12 minute TED talk “What makes a good Life. Lessons from the longest study on Happiness”, recently (http://ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness). This unique study, the longest ever undertaken to study happiness, tracked the lives of hundreds of young people, rich and poor, starting from their teenage to their nineties.  On expected lines, most youngsters, at the time of initial interview in 1930 when the study started, had mentioned money as the most important thing they thought they needed to make them happy. Some had said t

Diabetes and the Liver

One could wonder why in diabetes, a condition in which the blood sugar concentration in the blood goes up, need we worry about the liver? Or for that matter, even take the blood sugar reports seriously at all. Doctors have begun to realize that the elevated blood sugar value is only the tip of the iceberg. Patients with type 2 diabetes, the common form of the disease that occurs in adulthood, often go on to develop problems with several other organs of the body, such as kidneys, brain, blood vessels, heart, feet and the liver. At the root of the problem in Type 2 Diabetes, is the observation that contrary to intuitive logic, the blood levels of insulin in this condition is increased! Insulin resistance (IR) as its is called brings with it several changes in the body such as thickening of the basement membrane, the floor on which cells of all organs of the body are lined up and pushes up fatty acids in blood circulation, that then gets deposited in the liver and blood vessel

Health Care in Our Country

One recent morning while I was gloating about our country’s claim to be seated among the developed powerful nations of the world, my car stopped at a traffic signal and a dirty starving man begged me for some money to eat a meal. While parting with a tenner, I asked him what made him beg. He said he had been a small farmer in UP, but had lost his land, home, money and living, trying to provide treatment to his son who had been stricken with cancer for two years. Treatments have improved and many diseases are now curable, but they have come at huge costs that continue to spiral. And when a loved one falls prey to disease, emotions compel us to go to the last post to save his or her life. Administrators view healthcare sector as a graveyard for government investments. A government hospital does not fetch money on a regular basis, unlike manufacturing industries, housing, liquor or tobacco businesses. And the political benefits of cutting red ribbons of hospitals before elections

Food Fetish in Medical Descriptions

Strange as it may sound, doctors have an obsession for food items when describing body parts, organs or even human excrements. It often starts with the relatively innocuous description of kidneys as bean-shaped organs and the human brain as walnut shaped, that most students of biology are familiar with. But they soon go on to use “cafĂ©-au-lait” marks, salmon patches, and cherry red spots to describe different types of skin lesions that tell tales of diseases from a brown nevus or angioma or bleeding spots. And when doctors, who by the way derive their professional origin from butchers, delve inside the human body while cutting up corpses during autopsy, they resort to food items to describe what they see. If the liver shows alternating red and white stripes as in early cirrhosis the description goes as “nut meg liver”. If the intestine shows a central narrowing due to a cancerous tumour, an “apple core lesion” seems to depict it best. Familiar fruits are most commonly use

Eclipse of Hepatitis C

A hugely positive note with which 2015 is signing off on the medical front is the revolutionary treatment of Hepatitis C that is set to transform the lives of 12 million Indians and several fold more across the world. Around 1-2% of Indians harbour this chronic viral liver infection, most of them unknowingly and many coming to know of it when they have already developed liver cirrhosis or liver cancer. Treatment over the last 3 decades has been either unusually difficult, with weekly injections of interferon, or impossible (due to weakness or low platelets precluding this form of therapy). Three oral “miracle” drugs have burst into the world’s therapeutic arena, and what could not have been better is that this treatment is now available in India at less than 1% of the international price! Sofosbuvir is the prime new anti-viral medicine for treating Hepatitis C that was discovered and launched in USA and Europe by Gilead company at the prohibitive cost of US$ 1000 (Rs 6