Contact Lenses-Myths and Realities

Contact lenses,these tiny weightless and invisible pieces have changed the way each of us sees the world.Ask an actress,an actor,a model list has become endless for what contact lenses do for them,a thing which was introduced to correct eyesight issues and certain medical ailments has now become one of the major cosmetic tool.Eminent painter Leonardo da Vinci illustrated the concept of contact lenses in fifteenth century,for centuries different people tried to develop them,initial contact lenses were made out of glass which used to cover whole of the eye and were heavy making it cumbersome for use and were worn only for 2-3 hours.It was only in 1970s’ when American company Bausch and Lamb commercially launched soft contact lenses which actually revolutionized the idea of contact lens vision.Latest introduction to the list of available contact lenses are, Custom-manufactured silicone-hydrogel lenses launched in 2010.
There are three types of contact lenses:

• Hard lenses, the original type of contact lens, now virtually obsolete
• GP contact lenses or rigid gas permeables,or RGPs
• Soft lenses, made from gel-like plastic .
  • Conventional-used for months/year.
  • Disposable-used for a day/weeks/months

Contact lenses are like two edged sword,you use them properly –rewarded ,if you don’t –punished.Few years back U.S President injured his eyes while wearing contact lenses,so badly that he was probably hospitalized.
Numerous myths have been surrounding these little oval shaped structures,I’ve taken help from some of my opthal colleagues and contact lens companies websites to formulate this post.
1.Contact Lenses are just waste of money,a marketing gimmick.

• A myth,Contact lenses today has become the need of the hour,offering one of the most modern,reliable and non-invasive method of vision correction.
• Contact lenses have numerous advantages to a spectacle wearer and weighing the benefits they are not very expensive. Besides, due to technology enhancements and increased demand they are very much affordable.
• The advantages that contact lenses offer are:-
  • Contact lenses enhances field of vision and distortion free vision as they move with the eye movements.
  • Contact lenses give your natural looks back
  • Contact lenses are best for people who are in outdoor sports & other physical activities like dancing, jogging.
  • Contact lenses offer an opportunity to a spectacle wearer for sunglasses
  • During temperature changes, contact lenses do not fog up like spectacles do.
  • Contact lenses do not leave tell-tale marks on your nose as spectacles do.
  • Contact lenses helps you to change color of the eye,any shade/color –you name it and it is there.

2.Contact lenses will improve/stabilize eyesight.

• Contact lenses help only in clearer and better vision with advantages as written above,while offering no solution to refraction error or power no.,which are actually related to medical ailments in body,changes in eyes,etc.

3.Contact lenses are tough to handle

• No, not at all.Just a teaching of 20-25 min will do.lenses these days are easy to handle and use,you need to take care of sanitation and hygiene issues.

4.Contact lens are uncomfortable to wear.

• With modern technology and customized lenses ,after a brief adjustments and adaptation period ,they have become very comfortable to use .Yes to certain percentage of people they are troublesome but once cause is notified problem in general is resolved.

5.Contact lens maintenance is cumbersome and tough.

• Gone are the days when it was, one need to sterile them into sterilizer,dip into tablets,wash them after few hours,etc.,these days one bottle solution has made cleansing,sanitization and maintenance issue so easy. But if you are too lazy for that also opt for daily disposable or a month wear type lenses will do.

6.Contact lens could go inside my eyes.

• This is termed as wearied thinking ,till date how many times your tears or eyelash or any foreign particles got inside,answer would be no…Mother nature has taken care of this.A very thin invisible layer covers human eye and connect from inside to eyelid making this impossible..

7.Contact lens causes eye diseases/infections.

• This is a rare possibility these days if you a alert and do’s and don’t follower,but then certain people do get diseases which are mostly reversible after discontinuation of lenses.I’ve mentioned about possible complications at the end of this.Contact lens industry will never highlight this part but this should be kept in mind,after all eyes are most precious…

8.Contact lens – very high power means thickness and discomfort

• No not at all,with specialized material used and modern technology these days have made all lenses irrespective of power of same thickness.

9.Contact lens-Presbyopia/astigmatism means I can’t wear contact lenses.

• No,contact lens on the contrary improves astigmatism,a type of refractive error(toric lenses) and there are lenses for presbyopia(mono vision lenses).

10.Contact lens can come(pop) out of my eyes suddenly.

• Old hard lens had some problem but with the invent of these new lenses this is not a cause of worry any more.

11.Contact lens can’t be worn at night while sleeping.

• Ideally lenses should be removed after normal usage but these days continues wear category lenses are being introduced by lens companies in the market ,claiming they can be used for 30 days without removal/cleansing,this claim has been challenged by many ophthalmologist ,research paper of Dr.Umang Mathur-says lenses can be worn maximum for 6-7 days.

12.Contact lens –Conventional or Disposable.

• This is a general question asked , most of the people think that all lenses are same ,no,these days range of lenses have become vast ,so one needs to visit ophthalmologist to find suitable lenses. Here I’m just giving a slight comparison between the commonly asked difference.
• Conventional are cheap,last longer but are infection prone and ned high maintenance.
• Disposable are less infection prone,clarity of vision remains same through out as there is less deposition of protein and bacteria.
• Some claim that disposable lens provide high level of oxygen flow to eye making it healthy.I was unable to find any research paper/article on this issue.

13.Colored contact lens are harmful.

• No not at all,colored contact lens use FDA/other authorities approved color and material ,after all its all about eyes,but yes you cannot use them as frequently as normal contact lens,colored lenses these days are very common in movies,dramas and even normal parties to give a different look.

N.B;-RGP lenses are best suited for,Keratokones and Post R K Disorder.

• Lens industry always poses a rosy picture about contact lens usage but they might create some infections and might damage eye/power permanently if one does not adhere to guidelines of lens usage.
• Keratitis-symptoms.
  • Blurred vision
  • Redness/Itching of eyes.
  • Discharge/tear from eyes.
  • Pain.
  • Feeling of some foreign body inside eye.
• Corneal Ulcer.
• Corneal abrasions(scratches).
• Any quires to this post are welcome.

Gonorrhoea-Sexually Transmitted Disease/A summarized preview

One of the commonest STI ,caused by Neisseria gonorrhoeae.
This infection can spread from any form of sexual habit be it oral or vaginal or anal from the infected person.Prevalence of this infection is same in both genders,but in females particularly this infection severely effects their reproductive system and can even infect eyes.
Clinical Gonorrhoea Symptoms:- MALE

• Burning,pain and itching while passing urine.
• Abnormal colored and foul smelling discharge from penis.
• Swollen or redness over penis opening.
• Tenderness or swollen testicals.
• Increased frequency of urination.
• Sore and painful throat.

 Clinical Gonorrhoea Symptoms:-FEMALE

• Burning,pain and itching while passing urine.
• Increased frequency of urination.
• Abnormal colored and foul smelling vaginal discharge .
• Fever.
• Pain abdomen specifically lower abdomen.
• Painful Intercourse.
• Sore Throat.

Gonorrhoea leads to:-

• Infertility.
• Pelvic Inflammatory Disease.
• Salpingitis.
• Infection to fetus during pregnancy or newborn at the time of birth.
• Joint pain and infections.
• Infection leading to damage hart valve.
• Meningitis.

Gonorrhoea Prevention and Treatment :- Please refer this link on PID.

Pelvic Inflammatory Disease(P.I.D)-A summarized preview.

What is Pelvic Inflammatory Disease.
PID refers to female diaspora,in general.The usual infection starts from cervix/vagina of females involves female reproductive system(Endometrium and/or fallopian tubes)and may even extend further involving different organs/systems of stomach and near by areas.PID is sometimes caused due to other inflammatory foci,like inflammation in adjacent areas.,eg appendicitis or due to hematological manifestations eg.Tuberculosis or due to some other infections.Intrauterine infections are primarily due to STIs’ or secondary due to surgical procedures.
Pelvic Inflammatory Disease(PID) is caused primarily by N.gonorrhoeae which causes gonorrhea and sometimes by Chlamydia. trachomatis which is linked to be a causative factor for Human T-cell Lymphotropic virus Type-1.There are few other organisms also but I don’t think mentioning them over here is worth as my main intention is to make this blog for general public awareness and discuss about myths and misconceptions and not for medicos for whom tons of medical material can be found everywhere.

Clinical Signs and Symptoms for Pelvic Inflammatory Disease:-

• Fever.
• Abdominal tenderness.
• C reactive protein levels are increased.
• Abnormal vaginal bleeding.
• Yellowish vaginal discharge.
• Ano-rectal pain or bleeding-though rarely..

Main signs and symptoms to remember for PID risk:-

• Sexually active young females and even other sexually active females with prolonged pain abdomen where no other cause is found.
• Pelvic tenderness on manual pelvic examination.
• Cervical motion tenderness.
• Incidence of lower genital tract infections.

PID leads to:-

• Infertility.
• Increased risk of ectopic pregnancy and hysterectomy.
• Salpingitis,etc…

Prevention of Pelvic Inflammatory Disease:-

• Regular and periodic screening leads to early detection even in symptom free patient. One should be faithful,avoid multiple partners and casual encounters. 

Treatment of Pelvic Inflammatory Disease:-

• There are two goals for treatment :first is to treat the patient and secondly taking detailed history of sexual behavior from the patient and than locating each and every partner for treatment and curtailing spread of infections.Health providers in US are bound by the law to inform their respective health boards regarding gonorrhoea and clamydia diagnosed individual,law makes sure that patient turns for regular and prompt follow up and all its partners are located and treated.
• Regular and prompt Anti-biotic coverage.(Names of Antibiotics are not provided in fear of self-medication).
• Rarely Surgical intervention.
I’ve tried to summarize what PID is,avoiding many confusing and difficult terms,for any further clarification either drop a mail to me or meet your local health professional.

Sexually Transmitted Diseases/Sexually Transmitted Infections-Myths and Realities.

Recently, I received a mail from one Julia of Florida,age 40 years,asking me some queries regarding Pelvic Inflammatory disease(a kind of a syndrome related to STI).I was surprised  about the nature of questions which were asked,showed the extent of sheer ignorance and myths which may be prevailing in a civilized world like US,prompted me to leave other  posts and concentrate on the much burning and important topic-STD.or better known these days as Sexually Transmitted Infections(STI) or Venereal Disease ,over the next few weeks I will try to write as many possible myths and  realities about different infections .Curiously I tried to search about STI’s on different health and medical sites but most of them seem to have out dated material loaded or techniques which are not used these days.It is invariably not possible for me to write about each and every venereal infection separately but with best of my knowledge and resources available to me I have tried to compile about the most common myths.
STIs’ can be broadly classified into three types,which again are divided into three types,Bacterial,Viral and Others(Fungi,protozoan)

• Infections primarily through sexual route.
• Infections but not predominantly through other  routes,but sexual is a possible route.                                              
• Infections through Oro-fecal  route,In gay communities.                                                                                           

  SYNDROME AIDS Urethritis: males:- Epididymitis Lower genital tract infections: females:- Cystitis/urethritis Mucopurulent cervicitis Vulvitis Vulvovaginitis Bacterial vaginosis (BV) Acute pelvic inflammatory disease Ulcerative lesions of the genitalia Complications of pregnancy/puerperium Proctitis Proctocolitis or enterocolitis Enteritis Acute arthritis with urogenital infection or viremia Genital and anal warts Mononucleosis syndrome Infertility Intestinal infections Hepatitis Neoplasias Squamous cell dysplasias and cancers of the cervix, anus, vulva, vagina, or penis Kaposi’s sarcoma, body-cavity lymphomas T-cell leukemia Hepatocellular carcinoma Tropical spastic paraparesis Scabies Pubic lice I’ve compiled this list to make people understand that what all names are STIs’. With inputs from Harrison's Medicine.

Here I will write about  most common myths pertaining practically to all STIs’ but before doing so pals ,answer the following very nice effective questionnaire,every one should ask oneself.
TEN-QUESTION STD/HIV RISK ASSESSMENTFraming Statement:
In order to provide the best care for you today and to
understand your risk for certain infections, it is necessary
for us to talk about your sexual behavior.
Screening Questions:
(1) Do you have any reason to think you might have a
sexually transmitted disease? If so, what reason?
(2) For all adolescents <18 years old: Have you begun
having any kind of sex yet?
STD History:
(3) Have you ever had any sexually transmitted diseases
or any genital infections? If so, which ones?
Sexual Preference:
(4) Have you had sex with men, women, or both?
Injection Drug Use:
(5) Have you ever injected yourself (“shot up”) with
drugs? (If yes, have you ever shared needles or
injection equipment?)
(6) Have you ever had sex with a gay or bisexual man or
with anyone who had ever injected drugs?
Characteristics of Partner(s):
(7) Has your sex partner(s) had any sexually transmitted
infections? If so, which ones?
STD Symptoms Checklist:
(8) Have you recently developed any of these symptoms?
For Men For Women
(a) Discharge of pus (a) Abnormal vaginal discharge
(drip) from the penis (increased amount,
(b) Genital sores (ulcers) abnormal odor, abnormal
or rash yellow color)
(b) Genital sores (ulcers),
rash, or itching
Sexual Practices, Past 2 Months (for patients answering
yes to any of the above questions, to guide examination
and testing):
(9) Now I’d like to ask what parts of your body may have
been sexually exposed to an STD (e.g., your penis,
mouth, vagina, anus)?
Query About Interest in STD Screening Tests (for
patients answering no to all of the above questions):
(10) Would you like to be tested for HIV or any
other STDs today? (If yes, clinician can explore
which STD and why.)
Source: Adapted from JR Curtis, KK Holmes, in KK Holmes et al (eds):
Sexually Transmitted Diseases, 3d ed. New York, McGraw-Hill, 1999.
Myths and Realities.

1. I will not get infected with occasional change of partner.
   • A myth,sleeping with changed partner even once can infect you even though he /she appears to be a healthy lad,in my clinical experience generally people are reluctant even before medical professionals to accept about STI’s leave aside discussing with partners or many a times people aren’t aware that they are infected due to lack of symptoms,if infection is in early stage .While few infections like HIV have incubation period which may even last for years ,making one just a carrier and  infect others.
2. I will not get infected with use of condoms.
   • True to some extent that it is the best possible barrier available today but if used with a infected person regularly can give infection in event of a mal function,leakage of bodily fluids,rupture,etc.
3. I am already infected with one STI so I won’t be infected with other type.
   • This is one of biggest myths about STIs’,as written above STIs’ can be viral ,bacterial ,fungal,etc. meaning different kind of micro organisms are involved,so therefore an individual can suffer from two even three-four STIs’ at the same time.
4. I am pregnant so won’t get any STI .
   • This is one of the myth, I don’t understand that even highly educated women around believe,beautiful mothers !!!this is a complete non sense,rather any STI can create  havoc to mother as well as fetus, adding to it, many medicine used to treat STI may have a cascading effect on  fetus which may even surface after few years of child birth.
5. HIV cannot be cured so do other STIs’.
   • Yes HIV cannot be fully cured,but with proper treatment and care can be controlled to give patient a prolonged life span.
   • Regarding other STIs’ bacterial ones can be fully cured if diagnosed early and treated properly,few viral STI’s even have vaccines while other respond to anti-retroviral therapy.
6. I will not get infected by using oral or anal route.
   • No,any minor injuries or cut on skin will make micro organisms to penetrate into oral cavity or anus or genitals.
   • Few STI’s like Herpes can spread just by  rubbing or skin to skin contact or kissing with the infected person.
7. Contraceptive pills provide some protection against STIs’.
   • A complete myth,these pills are effective in controlling pregnancies,they have no roll whatsoever regarding STIs’,Condom is the best effective measure against STI.
8. Circumcision means no STIs’.
• A myth again ,this notion prevailed so strongly for years especially in African community that even people in Western world circumcised,but lot of studies over the years have proved this absolutely wrong.
• In fact ,many researches have proved that circumcision should be done when medically justified,otherwise it is like giving yourself pain and agony with no use at all.
• Please note I am not against religions/ethnic groups practicing circumcision but what ever I have mentioned is quoted from best researches available till date.

Child abuse myths and realities

Parents/guardian/wardens-this is a burning topic these days,prevalence of child abuse has increased many times,over the years.Data collected from different sources show,in 60-70% cases,people who are near and dear to the child are actually involved.
I've found a very nice video on you tube made by some Indian probably,which should be shown to each and every child.
Click on this link-   child abuse-myths n realities

Headache-Myths and Realities.

“I’ve been getting headache so bad that I cry often.It hurts everywhere on my top,back left side,right side.If this doesn’t improve I will kill myself one day”.This pain generally hurts me in early morning hours,remains their for few hours and then vanishes but it hurts and hurts very badly. Sound’s familiar ,yes this is a fact ,you must have heard people uttering these words……….
Headache or Cephalalgia(medical term)
· Broadly can be divided into three groups.

• Primary.
• Secondary.
• Cranial neuralgias.
• Primary :-
  • Migraine.
  • Cluster.
  • Tension.
  • Trigeminal Autonomic.
  • Sexual activity related (coital headache).
  • Few others
  • Secondary:-
    • Due to trauma leading to head/neck injury.
    • Some tumor,cyst,etc.
  • Cranial neuralgias.
    • Facial pain and other headache.

  I will try to explain about difference between types of headache in my coming posts.

  Headache-Myths and Realities.

1. All Headache are same.
• This is insane,as written above ,headaches are never same ,cause,duration,intensity,onset time may vary amongst individuals,as a result treatment also varies.
2. Tumors are the main cause for headache.
• A strange fact that tumors or even many serious disorders of brain rarely causes headaches,every second or third person suffers from headache in US,but only few thousands are diagnosed with Tumors.
3. Caffeine is the remedy for all types of headache.
• Low doses of caffeine might help in relieving certain types of headache or decreases intensity in many anecdotal reports but till date has not been subjected to any controlled study,prolonged and continues use of caffeine and related medication can make one dependent.
4. Botox shots are for beauty treatments only.
• No not at all,since few years botox shots are being popularly use to treat severe migraine but then like all other medication,Botox shots are not suitable for everyone.
5. Problem lies where your pain is.
• This statement does not hold any significance,your problem can be distance away,like severe headache in the frontal area can be attributed to falling eye sight numbers.
• Brain has no pain receptors,so it has no perception for pain,but ironically it is the brain which make us feel the pain in different part of body,reason behind is that though brain has no receptors,bones,skin other tissues around the brain has pain receptors ,so any disturbance in their area due to any cause leads to headache.
6. Sleep has no role in Headache.
• No ,it has.Lack of sleep,fatigue may cause severe headache,moreover excessive sleep can also trigger headache in few.
7. N.B, Any onset of sudden and severe headache with or without dizziness should be dealt seriously,it may be the beginning of some acute underlying pathology,like,Trans Ischemic attack,Sub Arachnoid Hemorrhage,etc.

Osteoporosis-Myths and Realities

Osteoporosis or commonly called as bone thief,is again a silent killer like many other NCDs'(non contagious disease).

Disease actually causes gradual thinning of bones i.e.,low bone mass and loss of bony tissue over the period of time may be years.It is perhaps one of the most common bone related disease. WHO data suggest significant prevalence of Osteoporosis,which is effecting millions worldwide,without people being aware of it.

Osteoporosis leads to fractures especially in areas like,spine,wrist,hip,skull,etc.if not taken seriously these fractures can make a person invalid or handicap for life.At times,few fractures may be non traumatic or not caused by any injury,these are tough to investigate as patients are not able elicit their condition and just complain of severe unbearable pain and complications depending upon the bone/joint involved.
Bones are formed by minerals-calcium and phosphorus –the most important ones.Calcium is required by the body to run its some very vital organs,eg,heart.Osteoporosis starts when due to some reasons body is unable to maintain daily requirement of calcium intake from unhealthy diet/any other pathological condition, thus it starts using  stored calcium deposits which is found in abundance in bony cage.Over the period of time gradually bones become weaker and thinner,there by a slight trauma may cause fracture..
1.Insignificant number of patients only suffer Osteoporosis.

• It is again a silent disease effecting millions worldwide and is increasing by leaps and bounces due to lack of awareness and poor understanding of disease.

2.Disease effects only third world countries or poor economies.

• A myth,every 2 out of 10 American suffer from some kind Osteoporosis,though it is primarily related to nutrition ,other factors also play  significant roles.

3.Osteoporosis effects only white females.

• Yes,some data suggest a slight increase in white females and Asian racial groups non the less it effects both genders equally and can happen irrespective to age,race and place.

4.Osteoporosis begins after menopause.

• Yes,condition deteriorates faster after menopause but to say that Osteoporosis begins after menopause is a myth,instead bone mass and density along with your lifestyle and diet at childhood and adolescence are the determinants of developing Osteoporosis in Adults.
• Osteoporosis develops gradually over years but in certain few illness and side effects of medication like steroids,can develop in weeks or months,though lately such cases are rarely seen.

5.Osteoporosis has a genetic trail.

• You are not doomed to develop Osteoporosis,just because some blood relation had suffered.With proper diet,alteration in life style and understanding of disease ,genetic risk can be overcome.

6.Osteoporosis has few risk factors.

• A strong myth,there are many factors causing disease,which include

• History of non traumatic/stress fractures.
• Irregular menopause,late starter of menses,history of amenorrhea without pregnancy.
• Small and thin built.
• Certain medical conditions-Diabetes,Kidney and liver disease,certain hormonal imbalance,anorexia nervosa,etc.
• Certain medications-Corticosteroids,steroids,heparin,certain anti-convulsants,furosemide,certain antacids,increased levels of thyroid hormone,etc.
• Lack of sun exposure.(vitamin D deficiency).
• Alcohol.
• Smoking.
• Inactivity or sedentary lifestyle.
• list is not exhaustive.

7.Taking milk products daily covers risk of Osteoporosis.

• A  strong myth,cow milk has certain high quantities of calcium but human body is unable to absorb it fully,secondly high content of phosphorus in milk excrete urinary calcium.
• It is not that milk products have no use instead,diet rich in calcium supplements,essential amino acids and other nutrients/minerals hold the key of healthy and sturdy bones.

8.Only Calcium supplements are required.

• Yes,calcium supplementation is required but along with other nutrients and minerals play a vital role in general upkeep of healthy bones.
• Minerals and Vitamins-Vit.D,Vit-B complex,Vit-C,Vit-K,Magnesium,silica,essential fatty acids.

9.All Calcium supplements are same.

• No,few forms of calcium are better absorbed and tolerated then others.
• Watch the labels for calcium citrate and chelates.
• Avoid calcium carbonate,as poorly absorbed.

10.Only Estrogen hormone therapy increases bone density.

• A Myth again ,estrogen only decreases bone loss .it in no way increases bony mass or density.
• Reports have suggested  excess synthetic estrogen has been linked to risk of Bbreast and ovarian cancer.
• Hormonal therapy should be initiated after conducting related test and after consulting relevant health consultant.

11.Present investigative tools aren't accurate.

• A Myth again,there are many reliable tools these days,
• Bone density test-DEXA SCAN(dual energy X-Ray absorptiometery),is the Gold test-informs about density of bones,risk and seriousness of Osteoporosis.
• Quantitative Computed Tomography is used in certain conditions.
• Certain Lab.Test have direct and indirect reference to Osteoporosis-
  • Blood Calcium levels.
  • Blood Vit.-D levels.
  • Thyroid Function Test.
  • Parathyroid Function Test.
  • Estradiol levels.
  • Estrogen levels in females.
  • Follicle stimulating hormone in females to establish menopausal status.
  • Testosterone levels in Males.
  • Osteo calcium levels to guess about rate and quality of bone formation.
  • Urine Test-24 hours collection to check 24 hours calcium metabolism
  • LIST IS NOT EXSAUSTIVE.

Thyroid-Myths and Realities.

Another disease under the banner of NCDs'.Thyroid disorders are extremely common worldwide effecting millions.Due to poor knowledge and sheer ignorance people are unable to judge about these disorders while confusing symptoms and signs with other better known diseases,till the time they realise,it is quite late,enormous harm has been done already. Thyroid is a butterfly shaped gland located just in front of the windpipe in the throat area. The function of this gland is to produce,store and release hormones-which have minor or major impact on each and every organ/part of the body. These hormones ignite the fire inside the cells for activation of metabolic process,i.e,regulate body metabolism.

• Hyperthyroidism:-When hormones are secreted in excess.
• Hypothyroidism:-When hormones are secreted less.
• Euthyroidism:- Condition when Thyroid Gland functions normally  and its secretions are proper of constituents and amount.

Risk Factors.:-

• Females more then 40 years.
• females within 6 months of delivery.
• History of Thyroid disorder.
• Prolonged Depression.
• Family history of Autoimmune Thyroid disorder.
• Non Autoimmune disorders like Type1 diabetes,Addison's disease,Rheumatoid Arthritis,etc.
• High levels of Cholesterols.
• Medical investigations involving Radioactive contrast agents/contrast dye.
• Radiotherapy for cancers and Hodgkins disorders.

Hypothyroidism:-Signs and Symptoms.

• Fatigue.
• Hoarse voice.
• Weight gain.
• Difficulty in swallowing.
• Mood Swings.
• Forgetfulness.
• Intolerance to cold.
• Dry skin and thin ill looking hair.

Hyperthyroidism:-Signs and Symptoms.

• Heat intolerance.
• Palpitations.
• Nervousness.
• Insomnia.
• Respiratory distress.
• Low and Absent Menstrual Cycle.
• Fatigue.
• High Heart Rate(Tachycardia).
• Tremors.
• Unusual weight loss.
• Muscle Weakness.
• Warm moist skin and hair.
• Increased Urination.

Thyroid:-Myths and Realities.

1. Thyroid Disorders are Contagious.
   • People often think on those lines as people in close net do suffer from thyroid disorders,it is actually due to prevailing conditions around,lets say in poor economies hypothyroidism is commonly noticed due to iodine deficiency so people linked it to affluence of neighbourhood as masses living in similar conditions might have common trend .But it is not a contagious disease,cannot spread by eating together,etc.
   • Iodine is necessary for normal function of the gland,it combines with Amino Acid of the gland to produceT3and T4 hormones.
   • It is actually a inherited disease,might run in a family tree.
2. Patient suffering from Hypothyroidism cannot loose weight.
   • The main culprit is fatigue factor,a common cause in pals suffering from low function thyroid gland are forced to live some sort of sedentary lifestyle,once underline cause is treated and thyroid hormones levels are normal they can start a more active lifestyle and regular exercise will surely help them shed as that fatigue is not felt.
   • Second factor is fluid retention which also increases weight in hypothyroidism above explanation goes for this condition also.
3. Patient suffering from Hyperthyroidism cannot gain weight.
   • Again one can gain weight back to normal or to desired levels as soon the thyroid hormones levels are normal.
4. Blood Test are not reliable.
   • Levels of TSH(Thyroid stimulating hormone) is often sufficient to diagnose the condition but more conformation is done by measuring levels of T3(Triiodothyronin) and T4(Thyroxin) levels also and believe me these test done at some reliable lab  suffice.
   • These days some labs have started conducting test like freeT3 and freeT4 which in fact are more reliable.
5. Post partum depression has no relation to Thyroid disorders.
   • Data suggest at least 10% of new mothers suffer from what is termed as post partum thyroid disorder,which includes females who have no history of thyroid disorders.
   • Most cases resolve by themselves few require medical intervention.
   • Thyroid test should be conducted in females suffering from depression.
6. Thyroid disorders can/cannot be  cured.
   • Hypothyroidism is a condition which requires lifelong medication ,it can be controlled/managed but can't be cured completely.
   • Hyperthyroidism is at times cured completely when surgical intervention is done to remove portion of thyroid or when treated with radio active iodine.
7. Alternative treatment therapies are more effective.
   • Some Yoga Gurus in India claim so,that with certain aasana (positions of Yoga) disease can be treated but lacks sufficient clinical evidence.

Bronchial Asthma-Myths and Realities.

Another deadly disease coming under the head of NCD,a very cruel and harsh disease,also called suffocating disease.During attack, if left untreated,it gives one of the worst and most painful death known to mankind. Patients and even medical professionals have poor understanding of this deadly disease as a result ,millions die,globally every year.
1.Asthma-It's all in one's mind.

• Is Asthma emotional/stress induced/psychogenic in nature.Answer is No.
• Asthmatic have some physiological condition involving their respiratory system,hence, in some sudden severe emotional outburst,at times,this could trigger a attack if one is already suffering from poorly controlled Asthma.

2.Asthma Is Curable.

• As said earlier in my previous post ,any disease coming under the banner of NCD.cannot be cured ,only can be controlled/managed.This stands true for this disease also.
• False propaganda managers quoting tall claims about permanent cure,exist in every society,even the most educated and civilised ones,ruining people of their precious time and money.

3.Pregnant Asthmatic have numerous complications.

• Years back this was not a myth, asthmatic mothers with poorly controlled disease were unable to carry normal pregnancy,as during pregnancy disease not only effects mother,it cuts/reduces  vital oxygen supply to foetus.
• Poorly controlled Asthma can trigger
  • Hypertension.Preeclampsia-a state causing increased blood pressure which has cascading effects on most vital organs and even on placenta.
  • Prenatal mortality-Death of new born at the time of delivery or just after.
  • Premature birth.
  • Intra uterine growth retardation-meaning foetus attains
• less weight and may have features of mental retardation in later part of life.
  • Now with modern understanding and treatment of disease leading to tight control of asthma and its complications ,any asthmatic can give even normal delivery like any other  female.

4.Asthmatic Child will out grow disease.

• In certain conditions where asthma is managed properly or situations /allergens causing asthma are notified asthmatic attacks are greatly reduced but asthma is a life long disease,so asthmatic child cannot out grow it..

5.Asthmatic cannot exercise/indulge in outdoor activity.

• With due precautions one can exercise or play like any other healthy person,carry your medication,notify your team mates about do's and don'ts,restrict out door activity during winters or places could have some allergic trigger.
• Consult your health professional before initiating any new physical activity.
• Learn about exercises mainly related to breathing which will help in the better management of Asthma and it's complications.

6.Alternative mode of treatments provide better control.

• A absolute myth,no such study has been published till date supporting this claim,worse even during the time of acute asthmatic attack only and only modern allopathic mediation works.
• Yes certain Indian Yoga postures/aerobic exercises help in controlling asthma,to some extent but that does not mean that one should stop treatment at all,asthma can sometime bounce back with severe life threatening conditions.

7.Regular use of inhalers is addictive.

• No,not at all ,many researches have shown that the first line of treatment to prevent asthmatic attacks are inhalers only.
• Inhalers are better then oral medication-
• Cost effective.
• Drug delivery directly at the place it is needed.
• Doses required are sometimes 40% less then oral .
• Few/No side effects.
• In fact ,over whelmed by the success of inhalers,researches are trying to develop inhalers for other diseases like Diabetes,Hypertension ,etc.

8.Steroids used are harmful.

• These days steroids are used seldom,instead corticosteroids are used
• Researches have shown that the corticosteroids used are lighter,practically with very mild side effects and of the same quality as used for facial products.

Any further explanations related to this topic or any other ,if sorted,are welcome.

Brain Stroke-Myths and Realities

 Another silent killer disease under the banner of NCDs',Brain stroke or Cerebral stroke or Brain attack- A disease spreading worldwide,costing millions of dollars to federal and other health systems across the  globe.Gone are the days when Brain Stroke was an earache of elderly or patients suffering from diabetes,hypertension and heart disease.These days people in their 30's, even in their early 30s, or 40s are being increasingly hospitalized with sign and symptoms of impending cerebral stroke or Brain stroke or have already suffered one.There is gross ignorance regarding brain stroke and people are unable to evaluate signs and symptoms leading to delayed medical intervention.Every 45 seconds someone suffers Stroke in USA. A Stroke is acute medical emergency as brain cells start dying fast and they do not regenerate easily.Speedy treatment is the key as 50-60% cases who suffer stroke for the first time have no symptoms,serious attention should be given to Brain Stroke as is given to heart attack.Initiating quick action can improve the odds of survival and better rehabilitation.
  Few signs and symptoms of Brain Stroke:-

•  Stroke has a sudden onset and best outcome is achieved by immediate and careful response to warning signs-
• Sudden onset of weakness/numbness of the face,upper or lower limb on one side of the body.
• Sudden facial deviation towards any side.
• Sudden difficulty in communicating skills i.e,unable to speak properly or unable to understand .
• Sudden severe headache without any reason.
• Sudden vision related problems.
• Sudden loss of balance and coordination,dizziness and difficulty in walking or even standing.
• Brief unconsciousness or sudden drowsiness.
• Nausea/vomiting.

Learn The Formulae of F.A.S.T.

• FACE:-Face drooped to one side?? Ask the person to smile.
• ARMS:-Weakness in any of the arms??,ask the patient to raise both arms –does one of them drift downwards.
• SPEECH:-Slurred or in coherent speech?? Ask the patient to repeat simple sentence.Is the sentence repeated correctly?
• TIME:-Any of these symptoms call for immediate medical intervention/rush to hospital.
• FAST-Courtesy National Stroke Association.
Risk factors:-
• Heart disease.
• Uncontrolled Diabetes.
• Uncontrolled blood pressure
• Smoking.
• Alcohol.
• High cholesterol levels.
• Obesity.
• Transient Ischemic attacks(TIAs).
• List is not exhaustive.
Permanent/Temporary problems after attack.
• Partial or complete impairment or weakness on one side of the body.
• Balance and coordination.
• Speech and Memory.
• Body ache.
• Numbness.
• Swallowing.
• Fatigue factor.
• Emotional setback.
• Vision.
Types Of Stroke.
• Brain Attack-One or more arteries supplying blood to different parts of brain are either partially or completely blocked. Also termed as Ischemic Stroke,approx.32000 brain cells die/second die in a acute ischemic stroke. 
• Heamorrhagic Stroke-Due to rupture of Brain Artery.
Myths and Realities.
• Recovery limited to initial few months or so.
  • Duration depends upon severity of injury and area of Brain involved.
  • Neurological investigation abnormalities though settle down in about a year's time but that does not mean that recovery is all done.
  • It is actually a life long process involving Doctors,Physiotherapists and full family support which plays main and important role.
  • Almost never does a patient recovers fully, the residual deficits are usually significant and permanent.The continual expectation of recovery can lead clients and families into denial, frustration, disappointment. Moreover, the successful rehabilitation of the Brain stroke person cannot take place until they and their family are aware of the new limitations, accept them, and formulate new goals based on changed expectations.
  • Hope and patience are the key words.
• Brain can not repair itself.
  • For years Neurologists,scientists used to think on these lines ,but latest researches have proved this theory a Myth.
  • Brain realign itself-grow axons to develop new pathways' so that the functional loss due to area involved could be minimised.
  • Brain has the unique ability to recover after brain stroke/head injury.
  • Brain weighs only 1% of body but consumes 10% of energy generated by our body.
• We use only 10%of Brain,if Stroke is in unused area no need to worry.
  • Have you ever heard Doctor saying although he has Brain Stroke/Head Injury it wasn't in the area being used.??
  • Brain uses every bit and corner of its parts,Brain mapping ,EEG and other test have proved this.
  • 10% idea was coined by Einstein people took it in the wrong manner.He meant that human use only 10% of Brain's ability.
  • It's like remaining 90% brain's potential is unused, should not be taken literally .
• Behavioural Changes are signs of madness.
  • Stroke mainly affects the emotions,it causes poor control of emotions and an improper or apposite reaction may be noticed at inappropriate times.
  • This is actually a neurological disorder that causes such behavioural disorders like sudden episodes of crying,laughing,etc.also known as Emotional liability.With proper therapy and care such disorders are minimized.
• There are limited and unreliable test to deduct Stroke.
  • A complete myth,Computer Tomography (CT)Scan and Magnetic Resonance Imaging(MRI) have completely revolutionised the management,treatment and better understanding of Strokes.
  • EEG.
  • Doppler Ultrasound.
• Treatment is often very limited.
  • Stroke treatment works on the theory 'the sooner the better'.
  • Neurologist have developed expertise to treat even the toughest cases through conservatives therapies but very often neuro surgeries play a vital and life saving role.

A formula of perfect diet-myths and realities

Since ages dietitians,nutritionist and doctors , world over,are trying hard for that perfect diet formula,though they have got substantial gains in their efforts,people due to lack of proper knowledge and awareness regarding diet are neither able to remain perfect healthy nor able to manage weight control /obesity despite following the tediousness regime of dieting/fasting.Diet and health are not "ONE PLAN FIT FOR ALL THEORY".individual goals are needed.
We know countless health cautious pals ,who want to get rid of their extra pounds permanently,this is here ,where starts a vicious  cycle of dieting,where some land up adding few extra pounds or extra fat,as people who want to drop extra pounds turn to the easiest method of dieting/fasting,disturbing natural metabolism of body.A recent study conducted ,suggested 95% who reduced weight following some diet plan landed up with extra pounds,with this they feel left out ,depressed and stressed.
Here comes the role of a healthy diet plan but despite possibly knowing many tend to choose wrong food.A close watch on dietary habits and notorious lifestyle of obese should explain about the wrong doings.
Before energizing yourself to enter into a dietary plan which actually leads to some changed life style ,try to answer the following? 
1.Under what circumstances/motivation factors you are choosing this path.
2.Are you ready for the change?
3.Are you ready to control your taste buds and become a non glutton.
Cautious approach and correct knowledge regarding your diet and eating habits are few deciding factors which will give desired success,but here prime importance lies in placing more realistic and practical approach with small but determined steps then taking some drastic change
Researches have shown that surprisingly workaholic also become over eaters as they find solace in eating to combat stress.
I've tried to compile few tips and suggestions which might help to attain goal about right diet.
1.Not hungry-don't eat.

• Follow the basic principle "Eat when hungry,sleep when exhausted".don't become a glutton ,train your body to eat  that you are just satisfied ,meaning there by that you are not over-eaten or under full.After few minutes that quest of extra craving will eventually go making you satisfied/comfortable with whatever you hv eaten. 
• Future eating-I won't have time to eat ,I have meetings lined up,so it's better to eat now-must be sounding familiar.This adds up extra calories.
• My favourite dish won't be available,so I may not be able to eat soon after this-makes you eat extra adding notorious calories unknowingly.
• Unable to sleep-that extra portion of cake/cookies might help me to sleep.

   2.Emotional eater.

• Ask yourself????
• Am I a Gourmet.
• Do at times I eat to please others.
• Do I  eat for rewarding oneself ,for some good work/favour I did.
• Holidays/weekends means celebrations,eat what ever .
•  Moment of sadness-food is best friend. 
• Do I eat for entertainment .
• Temptation hard to resist.   

    3.Prepare plate yourself and rule of half.

• Prepare half plate with fruits and veggies,half with products full of proteins and wheat.
• According to a study,people who take less food in their plates ,eat around 14% less then their usual diet as in order to fill in 2-3 servings are needed.

    4.Chew food properly.

• This makes people eat slowly and makes them eat less.

   5.Keep yourself busy.

• That extra craving for food is the real culprit,try to divert your attention towards something else,sneak out,do some work.
• If you really feel some craving ,take a glass of water,a fruit or a portion of some healthy snacks.

   6.Healthy food-better and improved health.

• Tongue taste should be restricted,choose some healthy alternative eg.instead of some fatty cookie,one can take few oil free nuts dipped in honey.etc.
• You yourself need to workout on new and improvised recipe so that healthy substitute taste good. 

   7. Beware of smart marketing and labels.

• Many so called self claimed health products or preserved/packed food,may contain substantially high sugar or salt contents.
• Even fat free /cholesterol free items are filled with trans fat and sugar.
• Check sugar content with different labels like,Sucrose,Glucose,fructose,Corn Syp., Maple Syp.
• Read thoroughly about the contents.

      8.Write what you eat.

• One of the best way to manage diet.
• Keep updating your diary -what ever you eat,even a small portion you eat,make a list,search for number of calories,make a chart.
• Add all calories at the end of day.
• Compile a list of your favorite food items.
• You will be surprised to know about the actual intake.

     9. Quantity and Management.

•  The best way to control quantity of food is to maximize the number of dishes in menu list,means instead of eating only one item you taste many,there by eating less.
• If you have craving for some item,don't stop but control, take a part of portion or better share with someone.
• If you are unable to stop yourself ,then follow the rule of management eg. take something light /less in your next dine in.

• Feel free for any quarries related to this article or any other.

Hypertension-myths and realities

Well one of the second largest killer  coming under the preview of non contagious disease.The World Health Organization (WHO) reports NCDs to be by far the leading cause of mortality in the world, representing over 60% of all deaths. 
 In US alone one in three has hypertension(HTn) where global index no better.
One of other disease coming under the head of non contagious disease ,also known as silent killer,you must have noticed people saying 'Oh he/she was alright till yesterday,had no symptoms with no major disease died of sudden stroke,MI or had a paralytic attack!!!!!!
     1.Don't feel any symptom.

• That is the reason it is called silent killer disease.
• Persistent hypertension creates risk for strokes,heart attacks/heart failure and still is one of the leading causes for kidney failure.
• HTn has a cascading effect on most vital organs as they are deprived of adequate blood supply and oxygen.
• Here comes the need of half yearly /annual health checkup so as to screen even what some call as pre hypertension condition.

     2.HTn means check BP every day.

• Initially yes,when one is prescribed with a new regime of treatment/change of drug or dose,but there after twice/thrice a week generally suffice but preferably at the same time  .
• Harmful effects occur over a period of long time i.e.years and not days/month
• Keep a record of average BP over month and show the pattern to your healthcare professional.  

   3.Normal range is 110/70 to 120/80 mm Hg.

• No,normal BP has now a slightly wider range depending upon ethnic groups,demographic locations and conditions,age gender,etc.
• Health bulletin released by WHO for country specific can be seen for that.
• But for US below 120/80 is normal.

    4.Manage either systolic or diastolic.

• No,a serious myth,both are equally important

  5.Blood pressure is controlled,so i can stop taking pills.

• Unfortunately like many other NCDs ,HTn cannot be cured ,once diagnosed,it can only be controlled/managed .
• The moment treatment is withdrawn there are high possibilities HTn bounce back.

     6. My BP is controlled by Pills meaning I can continue my old life style of smoking,alcohol     consumption etc.

• No,all these are excessive risk factors with continues excessive smoking,high alcohol consumption pills become less effective as arteries become harder & narrow with formation of plaque etc.

     7.All HTn pills have side effect and nothing can be done for that.

• Gone are the days when HTn pills had major side effects and nothing could be done but now scenario has changed,now doctors prescribe pills which are practically without side effects.
• But yes exceptions are there a pill which suits one might have some side effect for other,like ACE inhibitors might induce dry cough in some,but these effects are of mild nature ,do inform about even any slight change you notice.

    8.Old age means HTn.

• Age has no specific relation to HTn.
• There are many factors which cause hypertension-genetic,stress,lifestyle,kidney impairment,etc
• Collecting in simple words,HTn is caused when due to some reasons heart has to work harder to pump blood to different parts of body.

   9.High cholesterol levels means definitive HTn.

• Poor eating habits with sedentary life style may increase may increase both but not necessarily that high cholesterol means also high BP.

   10.Diabetic on insulin will become Hypertensive.

• There was a thought years back when insulin therapy was initiated,but with improvised insulin and techniques now we know that there is no substantial base to it.

   11.I am hypertensive suffers from severe headache means stroke is about to happen.

• No,severe headache can occur due to various reasons,though mild heaviness or mild headache can be associated with HTn.,but prolonged very high values might trigger severe headache or worse impending stroke,but then this is not always the case,individual body responds differently.
• Remember headache is not a disease ,it  is a symptom for some underline disease.

   12.Diet has no or minimal role in managing BP.

• DASH -Dietary approach to stop hypertension.system is now used worldwide to control blood pressure with minimal support of hypertensive pills.
• Further information can be seen at DASH

Diabetes-myths and realities

 I will not go into teaching what diabetes is,lot of research is being done by people who are diagnosed by diabetes,the word these days has fetch the name of being a silent killer,one of the worst disease et al.One of the largest killer disease coming under the head of Non Contagious diseases,Hypertension , Cerebellar stroke Asthma being the other few.
Numerous myths,misconceptions are being attached ,circulated via different means and ways,moreover when despite medication and other modes,abnormal blood sugar levels and other associated complications are seen patient really tries to believe many improper notions.
I have tried to collect few most common misconceptions out of my clinical experience.
      1.Diabetes is not a serious disease.
             Lot of recently diagnosed patients say "Sir we don,t think that diabetes is a serious disease"reason    being they don't feel any pain,etc or any symptom which is not the case.

• It causes more deaths in a year then AIDS,TUBERCLOSIS AND BREAST CANCER taken together.
• Two out of three diabetics die of Myocardial infarction and stroke.
• Every 6-7 minutes a limb is being amputated .
• Millions are spent by Fedral .and other govt.worldwide on medication and on complications.

     2.Eating lot of sugar related items causes diabetes.
      No,not at all,Dessert lovers,chocoholics,sweet lovers,etc. aren't destined to develop diabetes.

• It is actually a amalgam of too many factors,genetic(hereditary),life style,stress,obesity to name a few.
• A diabetic family profile from any side be it paternal or maternal should be a alarm bell for you.
• Follow the basic principle 'prevention is better then cure'-sweat a lot,exercise a lot,eat cautiously,check obesity,things will fall in line.

     3. Just cannot eat anything sugary.
       Avoiding isn't a compulsion but limiting the quantity is.

• Sweet/confectioneries have ready carbohydrates which increase glucose levels almost instantly and considerably,but then a piece of cake,part of dessert or few cookies won't harm if taken as a part of healthy diet combined with medication,exercise,etc.
• Follow the rule"Anything in excess is harmful".

    4.A diabetic child will not carry disease in adulthood.

• Childhood diabetes or Type1 diabetes or  juvenile diabetes or Insulin dependent diabetes  is caused by malfunction of insulin producing cells i.e. Beta cells of pancreas,which are destroyed by body itself .
• Hence a child will carry the disease till adulthood.
• Till date only treatment/management is possible no definitive cure is there,though trials are going on artificial pancreas,once a month insulin shots,nothing is affirmative yet..

    5. pregnant diabetic females have numerous complications..

• Years back this was not a myth, diabetic mothers with poorly controlled blood sugar levels were   unable to carry full term pregnancy due to self spontaneous abortion(miscarriage) or malformation in early pregnancy ,hypertension and premature babies in later pregnancy,also uncontrolled diabetes leads to high birth weight leading to unwanted severe complications for both mother and newborn,
•  Now with modern understanding and treatment of diabetes leading to tight control of diabetes and its complications ,any diabetic can give even normal delivery like any other  female.
• Gestational diabetes is a term used for females who develop diabetes during pregnancy which generally gets cure on its own after pregnancy but might carry on even after pregnancy.

     6.Diabetics are more prone to any illness..

• Again a myth,controlled diabetics lead normal life any other human being falling like any other,but yes some US guide lines say about the need of Flu shot,this is still controversial,as any illness makes diabetes a nightmare to control.
• Uncontrolled diabetes may lead to severe life threatening complications even in minor surgeries..
• CAUTION IS THE KEY WORD..

     7.Diabetics should not play outdoor sports activities.

• Moderate physical activities,exercise,brisk walk,etc are integral part of treatment and prevention of diabetes but diabetics with complications should first seek medical advice before initiating any new exercise in their regime.
• Diabetics with numbness/weakness in lower limbs should restrict jogging/brisk walking without special diabetics footwear,due to fear of unwanted foot injuries or foot ulcers,etc.
• Over enthusiastic or uncontrolled exercise regime can damage heart muscle permanently,in diabetics.

     8.Diabetics on pills/insulin can eat what ever they like by increasing dose.

• No,diabetics need to be utterly cautious about their food intake,all these pills try to regulate by bringing sugar levels near to normal by putting extra pressure on already fatigued out pancreas,so they can ill afford any extra glucose load cause by unregulated,unhealthy diet.

• Though insulin doses are adjusted according to sugar levels,overeating causes weight gain, cholesterol increase leading to other complications. 

     9.Diabetics should not drink alcohol.

• Moderate amount of alcoholic beverages with food does not cause much adverse effect on sugar levels but alcohol taken empty stomach may cause severe dip in sugar levels.
• Reports in insulin-dependent diabetics and even in healthy subjects have shown that acute alcohol consumption impairs the body response to hypoglycemia.
• Chronic or excessive drinking ,in contrast ,has been associated with hyperglycemia .Chronic alcohol abuse can reduce the body's responsiveness to insulin and cause glucose intolerance in both healthy individuals and alcoholics with liver cirrhosis.
• Any short spell of hypoglycemia can cause severe brain damage as brain CANNOT store glucose  and it relies exclusively on body glucose levels to cater its energy needs.

    10.Let diabetics enjoy life without medication eventually he/she has to die.

• Well this question is asked by few often,my reply is,u need to take diabetes like any other disease but with more caution,any disease left untreated will give unwanted complications,etc.

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.  ~Plato