Health Adda

One of the big mistakes that we as parents and teachers often make, and that could stifle the mental development of our children, is to treat them as just small adults! In fact, it is this attitude of grown-ups that could be leading our next generation to become stereotyped conformists rather than original thinkers and innovators. And if we intend to drive home health messages and inculcate healthy habits we need to tailor our efforts to their cognitive potential. That children indeed think and discover the world differently was first noticed by a Swiss scientist Jean Piaget in the early 20th century. He studied his own three children grow and was intrigued by how they behaved, played games and learnt at different ages. With further observations and experiments, he propounded the theory of ‘cognitive development’, placed great importance on the education of children and is hailed even today, 30 years after his death, as a pioneer of the constructive theory of knowing.  He not

The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to get closer to thei

Doctors may not be the brainiest in society; yet the fascinating ways in which they think and make decisions has been the subject of interesting research. A book by Dr Jerome Groopman that deals with the subject has hit the best-seller list. There are some parts of the brain that a doctor uses preferentially over others, memory being perhaps one of the most important to start with.  It begins from the time a youngster thinks of taking the entrance exam to medical school – he is required to read, retain and reproduce a large number of factual information and names of body parts and functions. Unlike the engineering, management, or law students, medical aspirants are hardly required to use mathematical problem solving, creative thinking, logic or thinking out of the box.  But ask them names and profiles of thousands of organs, tissues, cells and drugs, and they will have it on their fingertips! In the next phase as they progress to clinical work, doctors learn to recognize “p

Recurrent attacks of severe abdominal pain, renal stones, abnormal moods, and an attack of pancreatitis could well be due to an excess consumption of vitamin D. Dr Ambrish Mittal, a Delhi based endocrinologist, says he sees several patients with abnormally high blood calcium levels due to hyper-vitaminosis D, many of whom develop serious consequences such as swelling of the pancreas. Dr Vjay Kher, chief of nephrology at Medanta Hospital agrees that there is a lurking epidemic of vitamin D overdose resulting in high levels of blood calcium, that choking kidneys and causing renal failure. Vitamins are catalysts that in very small doses, regulate actions of several enzymes and make our body function smoothly. The discovery of this group of substances 100 years ago was indeed a major leap in medicine. Dr George Wald was awarded the Nobel Prize for discovering Vitamin A and proving its indispensable role in nurturing the rods in the retina that allow us to perceive light, and he

When the middle class Indian falls seriously ill today, he is caught between the devil of an exorbitant 5-star private hospital that could drain all his resources, and the deep sea of the swarming government hospital where he needs to be fit enough to stand for hours in long queues to reach the doctor or the scanning machine, sometimes to be told then to come another day! Let me start with the high-cost hospitals first. Have you ever wondered why they feature swimming pools, spas and shopping arcades selling Elizabeth Arden or Gussy? Do you think a “middle-class Indian” son who comes to see his mother suffering from terminal cancer, would   have a swim in the pool and shop for handbags after visiting hours? The message runs deep. It is a subtle way to tell those with shallow pockets “ Stay away. This place is not for you”. That “middle-class Indians” rush in to these mansions where angels would fear to tread indicates either their naivety or a deep desperation to provide the

A major health problem, appearing suddenly out of the blue, can squeeze the family’s resources to the last drop and land you in a debt trap, as I learnt from Rahul’s case recently. Twenty- year old healthy Rahul, who hails from a village near Agra, was perfectly well till the day before, playing cricket with his friends. That morning a gnawing pain started in the upper abdomen that increased in severity to a deep boring one and started radiating to his back. He threw up a few times, started sweating and became breathless. His father, Om Prakash, came back from the private sugar mill where he worked as a supervisor, and carried him in a borrowed 3 wheeler to the nearest local doctor. Sensing something serious, the doctor referred him to a nearby hospital. Having diagnosed Acute Pancreatitis, a condition that could turn potentially fatal, they referred him to a specialized centre. His condition continued to worsen, and Om Prakash could not bear to his only son of 6 children, fi

If you have piles, and ever get the feeling “Why did this have to occur to me?”, all you need to do is broach this topic in your next party and duck for shelter from the deluge of experience, anecdotes and advice that will follow.  I know that there are better things to talk about in a party than the swelling in your rear end. But parties are hardly everuniformly exciting, and you could pop this unusual topic if your attempts with sports, politics, economy and weather have drawn blank pauses from a grumpy next-seater. The first feeling you are bound to enjoy is the overwhelming reassurance that you are not alone.  Most would own up. In fact as the conversation and the circle get larger, you could give those who don’t have them or don’t know if they do, a bit of inferiority complex! A survey showed that one of every 2 adults have piles and the frequency gets higher as we grow up; many go through their entire lives not knowing if they had it at all while most get to know

Dengue is having a free run this autumn, thanks to the abundant rains, ramapant water logging and unrestricted breeding of mosquitoes. Almost every household has either had a bout of fever in the last month or is likely to in the next one. Recognizing Dengue Fever (DF): It is a viral infection transmitted by mosquitoes and presents as a sudden febrile illness of 2-7 days’ duration, with 2 or more of the following: Headache Pain behind the eye balls Severe body aches Pain in the joints Rash One of the main concerns in Dengue is the fall in platelet counts from its normal range of above 150,000. Platelets play a vital role in preventing or stopping bleeding from small blood vessels. Infusion of platelets is required only if they drop to below 20,000 or when there is active bleeding. Remember transfusions have their own risk of transmitting other infections, of allergic reactions, and their effect lasts barely a few hours. The other concern is shock. Dengue someti

“The quantity and quality of medical research being undertaken in India is embarrassingly little”, said Dr MK Bhan, secretary, Department of Biotechnology, Government of India, while addressing a group of Indian gastroenterologists in a meeting in Delhi on 1st Aug.  He painfully pointed out how research was a low priority amongst most medical schools, and how very few doctors were taking up research as a career option. Many might well wonder why research is important at all in medical science. Is it not well-established medical practice that a patient seeks from his doctor or hospital? The National Institute of Health in USA has shown time and time again how research improves teaching, and teaching lifts the standards of care. It might be hard to accept at face value, but an example or two may make it clear. The treatment of breast cancer, for instance has undergone major upheavals over the last few decades. It started more than a century ago with the concept that the tumor

Liver cancer, that recently claimed the life of the ever-smiling senior Maharashtrian politician and ex-CM, has become a hotly researched and discussed topic in hepatology meetings in the last few years. The reason for  resurgence  in interest in this disease, acronymed HCC (Hepatocellular cancer) stems from the recognition that it is the 5th commonest cancer worldwide, claiming around a million lives annually, but equally from the new understanding of this unique cancer, methods of its detection and specific treatment modalities that are indeed curing many. Cancer, as we all know and fear, has long been considered to be an universally and always fatal disease. Not any more! Doctors, who once talked of 1-year and 5- year survival rates are now beginning to talk of "cure". And HCC is joining this list after lymphomas, leukemias, colon and breast cancers. For one, doctors have realized that HCC usually does not occur in "anyone"; it needs a hot bed of a di

Funny as it might seem, patients who are warned too much of possible side-effects before being given a medication, seem to experience them more often. Describing this phenomenon as the NOCEBO effect, German researcher Winfried Hauser has recently shown that patients anticipating side-effects such as giddiness, headache, constipation or lack of concentration, experience them more often than those who take the drug without being told about them. This new finding fits well with what physicians have suspected all along, that the body’s response to therapy often depends on the patient’s belief with which he takes it. Some of the benefits of medicine undoubtedly come from the positive anticipation that a particular drug will work as intended -- easing arthritis or relieving wheezing, for example – called the PLACEBO effect. On the flip side our belief in a drug’s side effects may actually cause us to suffer from them as well. The role of suggestion and belief in obtaining a posit

The ovation that has marked Yuvraj Singh’s recent return to the cricket field has much more to do with just a cricketer’s homecoming to the lime-lit pitch. It has come to symbolize human triumph over a disease that has till now been considered invariably fatal. Yuvi’s  rendezvous  with the rare germ-cell cancer, starting from its delayed diagnosis, his hesitation to confront it and start treatment, the bewildering experience of seeing his bald head in the mirror, his anguish of having to sit away while his team played on the field have made his cancer a touching human story for the public. And, in our all too familiar Bollywood style of “All’s well that ends well”, his return to the cricket field with hair on his head gives us the deja vu feeling at the climax when the villain is finally bashed up by the hero. Our perception of cancer has been undergoing considerable change over the last few decades. Rajesh Khanna’s epic movie “Anand” depicted it as a “tragic” illness which

Affluence sometimes serves as a double edged sword, getting you and your loved one access to high quality medical care in 5-starred hospitals, but at times buying you heaps of misery and suffering as well. Mr Gupta’s 40 year old son, who looks after the family’s thriving business is unable to come to terms that his father cannot be saved despite any amount that he is ready to spend. Mr VK Gupta (name changed), 87 had been diagnosed with liver cirrhosis and has been ailing since then with weakness and swelling of his feet and abdomen. Last month he had slipped into liver coma and  respiratory  failure. The affluent business family, wanting the best treatment for their father, had air-lifted him to a very modern ICU in a posh tertiary care hospital in the capital for care. My encounter with the family was during ICU rounds. While an excellent team of doctors took as good care of him at par with the best hospitals of the world, he continued to sink. They monitored his his bloo

Mr Pradeep Kumar Srivastava, a common looking man, is no longer a common man. He has climbed roles from a  devastated  patient of Hepatitis B for 8 years to a hero who has cleared the infection and now to an activist guiding others to prevent and treat this deadly infection. And who can be more convincing than him to tell what it entails being a patient? The ground under his feet had shaken 8 years ago when he, along with his friends, had gone for a screening blood examination in 2004 and tested positive for Hepatitis B. Although he worked in a laboratory as a technician, he did not remember any accidental exposure to blood or blood products. He had never had jaundice, and had felt perfectly fine till this test had robbed his bliss. In disbelief, he got the test repeated from 3 labs. All were unfortunately positive! Advice kept pouring freely in. Some wondered how he was still alive, others said that there was no treatment and he was doomed to die, while many suggested going