pinkWhale Healthcare: 2015

Sunday, July 26, 2015

Green Gram Raita

It is summer time! Your body warms up naturally and you do not have the urge to eat proteins. But you cannot forego your protein intake for the season also. So here is a raita recipe prepared with green gram that ensures quality protein for the season and keeps you cool simultaneously.

Ingredients:

Green gram (soaked overnight) – 1 cup
Curd (naturally set) – 2 cups
Rock salt – quantity sufficient
Asafoetida – 1 pinch
Curry powder [a blend of dry roasted jeera, black jeera, curry leaves, red chilli and coriander seeds]
Coriander leaves – quantity sufficient
Molasses – 1 teaspoon

Steps to prepare Raita:

Steam the soaked green gram for 5 minutes with little salt. [You may use the soaked green gram directly but the amount of proteins your body absorbs with steamed pulse is higher than raw pulse. Raw pulse yields more fibre than proteins]
Cool and blend it in pulse mode.
Add chilled curd, rock salt, and asafoetida to it. Mix well.
Sprinkle curry powder and coriander leaves to your taste.
Chill and serve. Add a dash of molasses before serving [optional]

This can be used along with your main course or as a mid-day / evening snack.

Health Benefits of Green Gram:

According to Ayurveda, green gram is the best source of plant protein for any personality trait. Green gram is cold in potency and easy on digestion. It induces less flatulence relative to its legume counterparts and is the only pulse that can be advocated in any health condition sans doubt.

So eat you proteins the cool way this summer!

pinkWhale Healthcare Services is an e-Health company offering integrated online and telephone based personal healthcare services. Ask a Doctor Online. Ask a question for your health issues which will be answered by our doctor at your fingertips. Find a Doctor or Physician in Bangalore and Schedule appointments online instantly! Get Online Medical Second Opinion from Specialists to get answers to all your doubts.

Delaying Decline Of Testosterone Levels in Men

Testosterone [hormone produced by the testicles] is responsible for the proper development of male sexual characteristics. It also maintains muscle bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.

As a man ages, the amount of testosterone in his body gradually declines – less than 2% a year from around the age of 30-40 – and this is unlikely to cause any problems in itself. This natural decline continues throughout life.

Without adequate testosterone, a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating.

If you’re looking for ways to boost your testosterone level naturally, start by looking at your daily habits.

Some changes that are good for your overall health could also provide benefits in helping to maintain a healthy level of this important male hormone.

1. Get Enough Sleep.

A lack of sleep affects a variety of hormones and chemicals in your body. This, in turn, can have a harmful impact on your testosterone.

Make sleep a priority, aiming for 7 to 8 hours per night, even if it means rearranging your schedule or dropping your habit of late-night TV. Prize your sleep, just like you’d prize a healthy diet and active lifestyle. It’s that important.

If you’re having problems getting good sleep on a regular basis, talk to your doctor.

2. Keep a Healthy Weight.

Men who are overweight or obese often have low testosterone levels.

For those men, losing the extra weight can help bring testosterone back up, he says. Likewise, for men who are underweight, getting your weight up to a healthy level can also have a positive effect on the hormone.

3. Stay Active.

Testosterone adapts to your body’s needs. If you spend most of your time lying on the couch, your brain gets the message that you don’t need as much to boost your muscles and bones.

But, when you’re physically active, your brain sends out the signal for more of the hormone.

4. Get the right nutrients.

Zinc, Potassium, and Vitamin A: They are essential minerals that help in testosterone synthesis and sperm production.

Examples of Zinc foods include oysters, sesame seeds and sesame butter, low-fat roast beef, roasted pumpkin and squash seeds, and dried water melon seeds.

Natural sources of potassium include bananas, apricots, beets, cantaloupe, citrus fruits, dates, greens, prunes, raisins, spinach, strawberries, and watermelon.

Foods rich in Vitamin A include spinach, broccoli and liver.

Vitamin B6: Vitamin B6 helps boost production of testosterone.

Foods rich in vitamin B6 include fresh vegetables, whole grains and nuts, and whole milk.

Healthy Fats: Studies also show that reducing saturated fats in the diet and including more unsaturated (monounsaturated and polyunsaturated fats) can help boost testosterone levels. Go for fatty fish like herring, sardines, halibut and salmon.

5. Control Stress.

A study done by the University of Texas revealed that high cortisol (stress hormone) plays a role in blocking the influence of testosterone in competition and domination behaviours such as mating and aggression. The study done on 57 men found that when cortisol levels are high, they trigger the body’s “fight or flight” response.

pinkWhale Healthcare Services is an e-Health company offering integrated online and telephone based personal healthcare services. Ask a Doctor Online. Ask a question for your health issues which will be answered by our doctor at your fingertips. Find a Doctor or Physician in Bangalore and Schedule appointments online instantly! Get Online Medical Second Opinion from Specialists to get answers to all your doubts.

Transcendental Meditation Treats ADHD in Children

Studies suggest practicing transcendental meditation (TM) improves brain function and reduces symptoms among children diagnosed with attention deficit hyperactivity disorder (ADHD). The meditation showed improved brain functioning, increased brain processing, and improved language-based skills among ADHD students practicing it. Unlike other forms of meditation, Transcendental Meditation is designed to be practiced while sitting in a comfortable position and in a quiet location. Practitioners usually have a phrase or mantra that they repeat throughout the 20-minute meditation period. The repetition helps the mind move past the thoughts and even the awareness of the mantra to silence. It helps students by giving them an experience of silence, and wakefulness. This leads to changes in brain functioning so that the meditation experience begins to be integrated with waking experiences. Transcendental meditation promotes relaxation and is a better alternative to treat ADHD among children.

Transcendental Meditation (TM) is a technique for avoiding distracting thoughts and promoting a state of relaxed awareness. ADHD children find it difficult to pay attention, organize themselves and get things done when they’re under stress. While meditating, the person practicing TM sits in a comfortable position with eyes closed and silently repeats a mantra. When meditating, the ordinary thinking process is “transcended.” It’s replaced by a state of pure consciousness. In this state, the child achieves perfect stillness, rest, stability, order, and a complete absence of mental boundaries. So it stands to reason that the TM technique which reduces stress and organizes brain function would reduce ADHD symptoms.

The Transcendental Meditation technique may be an effective and safe non-pharmaceutical aid for treating ADHD. Medication for Attention Deficit Hyperactivity Disorder (ADHD) is effective for some children, but it is marginally or not effective for others. Even for those children who show improved symptoms with the medication, the improvement is often insufficient or accompanied by troubling side effects associated with the common ADHD medications, including mood swings, insomnia, spasms, slowed growth, and heart problems. These high risks and growing concerns are fuelling parents’ search for alternatives that may be safer for their kids. And since the meditation technique is self paced and does not involve any drug intervention it is recommended as one of the better alternatives to treat ADHD in children.

Meditation, both Transcendental meditation and other forms, is generally safe for ADHD among children, and improves quality of life. Even though Transcendental meditation is proving to be both an enjoyable and an effective treatment, we also encourage you to continue your normal treatment. But when Transcendental meditation is synced with the main treatment for ADHD among children, they will soon notice that they spontaneously require less medication; but it is very important for this to happen in small steps and in consultation with one’s doctor.

Saturday, July 4, 2015

Musculo-Skeletal Disorders In The IT-Workforce

IT workers spend many hours at computer workstations, using the same set of muscles without enough rest. This can lead to strain on the muscles, tendons and ligaments and this condition is called Repetitive Strain Injury or Cumulative Trauma Disorder. We will tell you the usual causes of this disorder and its prevention.

What are the common causes of Musculoskeletal disorders among IT workforce

These disorders are very prevalent in IT workers. Some surveys report a 1 year prevalance at 24-44%. Constant repetitive movements will slowly damage the muscles and ligaments of the neck, shoulder, forearm and the hands. Lower back problems are frequently encountered.

Certain patterns of strain are noted, such as:

Tendinitis, where the tendons are inflamed and tender. This is seen in the forearm tendons.
Carpal Tunnel Syndrome, where a thick band develops in front of the wrist trapping the nerve, causing pain and numbness in part of the hand.
Epicondylitis or tennis elbow can also occur in keyboard operators. Here the area of bone where the tendon is inserted gets inflamed and can be quite painful.

Symptoms:

Symptoms depend on the area affected but they start slowly and can progress if neglected to the extent that the person can end up having continuous pain. Symptoms can include pain and tenderness along the muscles and tendons, swelling of joints, numbness, etc. This may result in a lot of time off work and some badly affected persons may even have to stop using the keyboard. Persons with arthritis and similar conditions quite often note that their symptoms are aggravated.

How are these conditions treated?

Severe symptoms will require rest to heal the tissues.
Workers could work at other jobs while resting their hands. Keyboard operators may not be able to avail this option and may have to take time off.
With ongoing symptoms, a doctor must be consulted. Most IT companies have clinics with doctors trained in Occupational Medicine. Referrals may be needed to a Neurologist or Rehabilitation specialist.
The affected hand can be splinted to allow it to rest.
Massage and physical treatments are very helpful.
Medicines for arthritis (nsaids) are generally not very effective but will provide some relief.
Depression and other psychological disorders are commonly seen and need to be treated on their own merits.
Specific treatments are available such as surgery for Carpal Tunnel syndrome or steroid injections for epicondylitis.

How can these disorders be prevented?

Prevention starts with good design of workstations, good lighting and other measures to ensure the comfort of the IT worker.
Employers are obliged by law to provide such amenities and to properly train workers to minimize repetitive strain injuries.
Wrists should be in the neutral position and the least force should be used in striking the keys.
Chairs should provide good lumbar support and the feet should be firmly on the ground.
Monitors should be adjustable and all materials should be easily reached to avoid twisting the neck and the body.
Soft wrist supports should be available and the forearms should not be raised too much.
IT workers should be allowed breaks to stretch and exercise . Yoga and regular physical exercise is beneficial.
Companies should employ people to look into ergonomics which deals with working conditions and how to provide the ideal safe environment for the worker.
A combined effort by the employer and worker is needed to minimize these musculo-skeletal disorders.

Ask a Doctor Online queries related to Heart attack on the platform of pinkWhale healthcare which provides online healthcare service for individuals. Find a Doctor or Physician in Bangalore and Schedule appointments online instantly! Get Online Medical Second Opinion from Specialists to get answers to all your doubts. Also pinkWhale healthcare members can request for Doctor Second Opinion from a panel of experienced Specialists who are associated with leading hospitals.

Dengue Fever

Dengue is the second most common mosquito borne infection after malaria. It is seen mostly in tropical and sub-tropical countries. We will explain how it spreads, the common symptoms and what can be done to prevent this painful infection.

What causes Dengue?

Dengue or ‘break bone fever” is caused by a virus with 4 variants and is transmitted by a mosquito called Aedes Aegypti which bites in the daytime. Dengue Hemorrhagic Fever (DHF) is a more severe version, with bleeding into the skin and internal bleeding. Dengue is seen in many countries and up to 100 million people can be infected every year.

In India, there are frequent outbreaks in many regions. Dengue occurs in urban and rural areas and the Aedes mosquito tends to breed in containers or collections of water around dwellings.

What are the symptoms of Dengue?

Symptoms start 3-14 days after the bite of an infected mosquito.
The illness last 2-7 days and there is fever, severe headache, severe eye pain and severe muscle and joint pain, hence the name “break bone fever”.
Small red spots are seen on the skin and there can be bleeding episodes like nose bleeds or bruising under the skin. In severe cases, there can be bleeding into the gut, shock and collapse. This condition is called Dengue Shock Syndrome. Urgent hospital treatment is needed if there is severe abdominal pain, vomiting of blood or signs of shock.

Dengue can be fatal but with good treatment, the mortality rate can be kept under 1%.

However, outbreaks in Delhi in recent years have had mortality rates in the region of 4%.

Dengue is becoming a major health problem in India and is becoming entrenched in many cities. Outbreaks occur during the monsoons and soon after, as water collects in numerous containers.

What tests need to be done?

The blood is tested for the platelet count. Typically, platelet cells drop to low levels. The white cell count is also low. If dengue is suspected, within 5 days blood is collected for virus isolation. After 6 days, an IgM antibody for Dengue will give a specific diagnosis.

How is it treated?

There is no specific treatment although some anti-viral drugs have some effect.
Fluid intake must be kept up and painkillers given.
Aspirin and ibuprofen must be avoided because they may increase the bleeding tendency.
Severe infections must be treated in hospitals and blood transfusions may be needed.
How can Dengue be prevented?
There is no vaccine although some are being tested.
The key to prevention is by mosquito control. The female mosquito transmits the virus and eggs are laid in water.
All households should cover water containers and ensure that containers which collect rain water are cleared once a week.
Personal prevention against mosquito bites in the daytime include repellents like DEET, protective clothing and screening windows.
If there is an infected person in the household, extra precautions must be taken to prevent the patient from being bitten.
Clothing can be impregnated with permethrin.

Acute Pancreatitis In The Aged Population

Acute pancreatitis refers to inflammation of the pancreas, causing sudden and severe abdominal pain. Pancreas is a gland that produces digestive juices and certain hormones, including insulin. Pancreatitis usually develops as a result of gallstones or moderate to heavy alcohol consumption over a period of years. Acute pancreatitis (inflammation of the pancreas) is common in older people. It is responsible for 5-7% of the cases of abdominal pain in older persons.

Causes:

In old age it occurs primarily due to

gallstone induced biliary tract disease
drug induced pancreatitis
alcohol
pancreatic cancer

It occurs most often in women.

Signs and symptoms:

Acute illness is characterized by:

sudden, constant pain in the upper part of the abdomen
nausea
vomiting
In severe cases, the initial symptom may be shock or coma.

When the disease is more severe it is characterized by:

sepsis
pancreatic abscess
shock

Diagnosis:

Diagnosing acute pancreatitis can be difficult because the signs and symptoms of pancreatitis are similar to other medical conditions.

The diagnosis is usually based upon a medical history, physical examination, and the results of diagnostic tests.

Two of the following three are required to make a diagnosis:

(1) typical abdominal pain;

(2) threefold or more elevation of pancreatic enzyme values in the blood; and

(3) inflammation of the gland on computed tomography (CT) scan or magnetic resonance imaging (MRI) scan.

Once a diagnosis of acute pancreatitis is made, additional tests are needed to determine the underlying cause. This ensures that the correct treatment is given to prevent pancreatitis from recurring.

Imaging tests — Imaging tests provide information about the structure of the pancreas, the ducts that drain the pancreas and gallbladder, and the tissues surrounding the pancreas. Imaging tests may include an x-ray of the abdomen, chest, CT scan or MRI of the abdomen

Endoscopic retrograde cholangiopancreatography (ERCP) — ERCP is a procedure that can be used to remove stones from the bile duct if your pancreatitis is due to gallstones or other problems with the bile or pancreatic ducts. In addition, ERCP can be used to treat some causes of pancreatitis

Management:

Treatment usually requires hospitalization for at least a few days.

Mild pancreatitis

monitoring
drugs to control pain and
intravenous fluids
You may not be allowed to eat anything during the first few days if you have nausea or vomiting

Moderate to severe pancreatitis

Moderate to severe pancreatitis requires more extensive monitoring and supportive care. This is because severe pancreatitis can lead to potentially life-threatening complications, including damage of the heart, lung, and kidneys. People with pancreatitis of this severity may be closely monitored in an intensive care unit.

During this time you may be given one or more of the following treatments:

Intravenous fluids are given to help prevent dehydration.
Most people with moderate to severe pancreatitis will not be able to eat in the early course of their illness. Instead, you may be fed through a tube placed through the nose or mouth into the small intestine.

If you cannot tolerate tube feeding or cannot get enough nutrients with tube feeding, you may be given nutrition through an intravenous line placed in the upper chest. You can resume eating gradually once your pain resolves and bowel function returns to normal.

About 30 percent of people with severe acute pancreatitis develop an infection in the damaged pancreatic tissue. Antibiotics can prevent infections and control infections that are already present.

Acute pancreatitis is sometimes complicated by extensive damage and/or infection to the pancreatic tissue. In these cases, the damaged and/or infected tissue may be removed in a procedure referred to as a necrosectomy. Necrosectomy can be done as a minimally invasive procedure.

Friday, June 19, 2015

Diabetes Care – Diabetes And The Eye

Eye is the window to most systemic diseases. Diabetes mellitus is the most common disease affecting the current population between the ages of 30-65. Regular eye examinations help detect sight threatening and life threatening complications.

What is diabetic retinopathy?

It is a condition which occurs in the nerve layer of the eye called retina due to abnormalities in the tiny blood vessels called capillaries.

It is characterized by:

Micro aneurysms: These are the earliest clinical abnormality detected. They appear as small red dots. T

Hemorrhages: These most characteristically occur in the deeper layers of the retina. They appear round, regular and are described as ‘blot’.

Hard exudate: These are tiny specks to patches of confluent yellowish material deposited in the retina, close to the macular area (center point of vision). They result due to leakage of plasma from abnormally permeable capillaries.

Soft exudate: These are also referred to as “cotton wool” spots. They indicate nerve fiber layer infarcts or advancing arterial occlusions.

Neovascularisation: New blood vessels arise from the existing blood vessels on the optic nerve or the retina. These new vessels grow in response to capillary closure and decrease blood supply in the retina. They are fragile, leaky and often rupture causing hemorrhage, which may be within the layers of the retina, or into the vitreous cavity. The products leaking from these vessels, promotes the growth of fibrous tissue, which on contraction brings about retinal detachment and loss of vision.

Venous changes: Veins show sausage like dilation.

Based on the prognosis for vision, diabetic retinopathy is classified clinically as mild, moderate and severe depending on the extent of involvement of retina by the above mentioned features.

How can a diabetic detect, prevent and manage diabetic retinopathy?

There is good evidence that good metabolic control in the early years following the development of the diabetes reduces the chance of developing retinopathy. Usually 5 years is the time for the appearance of these changes, but it may vary between individuals.
Control should be assessed by reviewing HbA1c ( levels between 6-6.5 is desirable)
Control high blood pressure
Stop smoking
Limit alcohol intake
Exercise regularly

Note: Rapid lowering of blood sugar levels may result in worsening of retinopathy, which may require laser photo coagulation.

Early diagnosis and effective treatment is the key to preservation of vision.

All diabetics must undergo a dilated eye examination by an ophthalmologist at the time of diagnosis of diabetes and then on:
Yearly once if no changes are present.
Once every six months if early changes are present
Once every 3 months if changes are very close to the macula (sight threatening)

What is done if sight threatening changes are detected?

Laser photo coagulation offers effective treatment if given at an early stage when patient is symptomless.

Note: Most often early diabetic changes are symptomless and detected only on dilated eye examination. Unless the macula is affected or there is a vitreous/ retinal hemorrhage which causes sudden drop in vision; diabetics rarely have an eye examination.

What is laser photo coagulation?

Laser photo coagulation destroys the areas of retinal ischemia (less blood supply), which is a precursor of new blood vessels.
It seals the leaking micro aneurysms
Directly obliterates the new blood vessels.

Laser photo coagulation is an outpatient procedure and the person can resume his/her activities following the procedure (Exception: if vitreous hemorrhage is present and photo coagulation has been done, bed rest is often advised).

Are there any surgeries for diabetic retinopathy?

Advanced diabetic retinopathy where the hemorrhage does not clear within 6 months or there is extensive growth of fibrous tissue or retinal detachment needs surgical intervention.

What are the other possible problems seen in the eye?

Fluctuating refraction (power of the eye): Raise in blood sugar levels results in short sightedness and low levels result in long sightedness.
Cataract: Early development or hastening the progress of existing cataract is often seen.
Glaucoma: Rise in intraocular pressure.

The Language of Doshas

The physical, psychic and cosmic language of the body is created from the circadian rhythm of the universe set in motion. Space, air, fire, water and earth are the first materials for life. In Ayurveda, human body is rooted in bodily humors called doshas. They are three in number namely Vata, Pitta and Kapha. These three principles support all of life and are more than the physical substance of our anatomy. They are the messengers of communication that inter phase the external and internal nature.

How are doshas formed?

When existing in the living body of all organisms, the panchamahabhuta congregate in certain pattern and are known as doshas which literally means ‘that which is quick to go out of balance.’

What do doshas imply?

Doshas imply that the human system maintains a delicate balance or homeostasis, its dynamic elemental composition always being on the verge of disorder. The human body intimately interacts with doshas which are more energy than matter until they manifest as diseases in the organism.

The doshas are classic example of energy and matter in dynamic accord. All matter born of energy remains intricately woven within its core nature of energy.

In a state of balance doshas are energy force as they move through and support the body functions. In a state of imbalance they become visible as mucus, bile, wind, and physical matter. When these early signs of disorder are ignored, imbalances cab quickly become full blown diseases.

Types of doshas and their elemental composition:

Vata is composed of air and space. Here air exercises its power of mobility only when space is available. For example, movement of fluids in body’s arteries is possible only if space is available in the channels.

Pitta is composed of fire and water. Here the bodily water protects the heat of the body from burning through. For example, the acid in the stomach is protected by the mucous membrane of the stomach.

Kapha is composed of water and earth. Because of their mutual density water gives earth its fluidity. For example, fluidity in body is enabled by kapha dosha without depriving it of its solid support.

These doshas co-exist in all living organisms. The degree to which they exist within a person determines the individual constitution, commonly referred to as body type.

Friday, June 12, 2015

Common Cold

Atchoo! (sniff-sniff) – Oh … looks like I am coming down with a cold! Read more to know how to soothe your symptoms …

The medical terminology of Common Cold is “Viral Rhinitis”.

What causes cold?

The causative agents are the numerous types of viruses, to which an individual is susceptible throughout life.

Individuals are susceptible to cold especially during change of seasons.
Lowering of immunity (the ability to fight an infection) due to stress (either mental or physical e.g., loss of sleep, overwork etc.)
Exposure to extremes of temperatures like cold and heat.

What are the symptoms?

Sneezing
Watery nasal discharge
Blocked /stuffy nose
Headache
Itchy feeling in the throat
Body ache and mild fever
Loss of smell, taste and appetite
Repeated wiping of the nose making it red and sensitive; skin may be excoriated around the nostrils.

How can one get relief from these symptoms?

The fact is there is no curative treatment for a cold.
There is a misconception that antibiotics are helpful but they are not.
Supportive treatment with decongestants, antihistamines and anti inflammatory do help but one gets relief only after the cold has run its course of 1 week or 7 days.
The use of decongestant nasal sprays should be limited. They bring about immediate relief, but continuous use causes rebound congestion, and headache which are worse than the original symptoms.

Are there any complications of common cold?

Yes, as persistence of symptoms beyond one week associated with purulent nasal discharge is suggestive of bacterial infection (sinusitis) for which antibiotics may be required.
Middle ear effusions and infections can also occur.

Tip: Avoid blowing your nose, as it spreads the infection to the sinuses and middle ear.

What should one do while having a cold?

Plenty of rest and water for the first 24 hours. Fresh fruit juices like sweet lime (mousambi) can be consumed thereafter.
Relief from blocked nose can be obtained by inhaling vapours of Eucalyptus oil (put two to three drops of eucalyptus oil in steaming water or on your handkerchief and inhale).
Consume bland food like rice conji, vegetable soups with pepper and garlic which are soothing.
Avoid refrigerated food.
A spoonful of honey does well to soothe the throat.

Tip: Washing hands prevents the spread of infection.

How can one prevent getting a cold?

The solution is to increase your level of immunity, which can be developed by daily regime of balanced diet which includes fresh fruits and vegetables along with pulses and cereals.
A teaspoon of honey in warm water every day before meals.
Get adequate sleep and avoid overworking.