pinkWhale Healthcare: June 2015

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.

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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.

Monday, June 8, 2015

Risk Factors of Heart Attack

Heart is an organ which pumps blood 24×7 and keeps our circulation going. What happens when this pump does not function? Read more……

Introduction:

Our heart is a muscular pump which needs oxygen to function like any other organ in the body. It is supplied by blood vessels called “coronary arteries and veins”.

When one or more coronary arteries get blocked, the blood supply to that portion of heart muscle is cut off and the resultant symptoms due to this is termed “heart attack”.

Causes:

Plaque (cholesterol)
Clot which is usually formed upon rupture of the plaque
Clots from the heart or veins in the lower extremities
Emotional disturbance, which can result in spasm of the arteries

Risk factors include:

Older individuals(Males >Females)
Menopausal women
High blood pressure
Diabetes Type 2
Smoking
High cholesterol
Obesity
Persons with pre-existing heart disease
Family history /heredity

Signs and symptoms

The symptoms are:

Sudden, but not instantaneous, central chest discomfort or pain (usually felt as gas or pressure).
The pain typically

May last for a few minutes and go away and recur. It builds up rapidly or in waves to maximum intensity.
can radiate to arms, back, neck, jaw or stomach.
is not relieved by rest unlike angina.

Shortness of breath can occur before or after the chest discomfort.
Nausea, vomiting, light-headedness, wheezing.
The persons appear apprehensive, anxious and sweating.
There may be no symptoms at all (silent heart attack).

Note: Symptoms can present singly or in any combination.

Management:

Quick recognition and prompt treatment is the key to efficient management of a heart attack.

An ambulance should be called for immediately and patient shifted preferably to a hospital with cardiac care services. Ambulance provides immediate care to the person till the hospital is reached.

Investigations:

ECG (electrocardiography) is done to know the extent of damage.
Blood is drawn from the patient to check for heart specific markers, which are usually raised in an acute situation.

Once the diagnosis is confirmed, measures are taken to restore the blood supply to the heart. It may include:

Medications to dissolve the clot /relieve spasm
Investigative and interventional procedures like coronary angiography (viewing of the coronary arteries by injecting a dye into a vein in the groin), angioplasty (widening of the coronary arteries) and placing of stent (a device which will keep the artery open) are performed. All the procedures are usually performed at the same sitting.
Blocks which are not amenable to the above are treated surgically. The procedure is called “Coronary Artery Bypass Surgery” (CABG)

General measures include:

Continuous monitoring of the person for 24-48 hours.
Maintaining oxygen flow
Administration of medications to relieve pain, prevent re-clotting and decrease load on the heart.

Depending on the presence or absence of complications, patient is shifted from ICU to the ward and thereafter discharged home.

The treatment does not stop at the hospital but continues upon discharge at home also.

Home based care:

Immediately call for an ambulance
Make the patient rest

Complications:

Arrhythmia: absence of coordinated activity of the heart muscle
Asystole: Heart comes to a standstill
Congestive heart failure: If a large area of the heart muscle is affected, it is replaced by scar tissue, which lacks the ability to pump blood

Preventive Measures:

To prevent a repeat attack:

Effective control of blood pressure and high cholesterol and triglyceride levels.
Taking regular medications to prevent blood clotting
Cessation of smoking
Exercise as tolerated and advised
Dietary alterations and lifestyle changes
Regular follow up with cardiologist

Information for travelers:

All cardiac patients should carry their regular medications, prescription and contact details of their treating physician on their travel. A check-up prior to travel with their cardiologist is advised.

"Chest discomfort!. Does it occur in the chest or in the arms, back, or jaw? If you have symptoms, take notice. These are your heart disease warning signs." Quick recognition and prompt treatment is the key to efficient management of a heart attack. Ask a Doctor online queries related to Heart attack on the platform of pinkWhale healthcare which provides online healthcare service for individuals who would like to consult specialists and doctors remotely for their health ailments. Also pinkWhale healthcare members can request for Doctor Second Opinion from a panel of experienced Specialists who are associated with leading hospitals.

Thursday, June 4, 2015

Cooking your Iron foods – Dos and Donts

Do’s:

Cook Iron rich foods in Iron vessel to ensure additional contribution of Iron into your food
Cook in low to medium heat to avoid oxidation of Iron in food
Prepare your Iron rich foods spicy / salty / sour to ensure maximum absorption of Iron by your body
Cook and consume Vitamin C rich foods like Amla, orange, and turnips along with Iron rich foods

Dont’s:

cooking and consuming calcium rich foods like milk
drinking tea, coffee
consuming poorly processed / cooked grains and pulses and
consuming raw fibre
consuming fatty foods

along with your Iron rich foods

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Methods to Prepare Buttermilk !

Did you know that there were unique ways to prepare buttermilk to suit your appetite better? Here is how it is done:

There are three different ways by which buttermilk can be prepared suitably:

To one part of naturally set curd add three parts of room temperature water. Churn well, add a pinch of rock salt and use it per se if you have irregular or unpredictable appetite.

To one part of naturally set curd add three parts of cool water. Churn well, remove half of solid fats from it, add sugar and use it if your appetite is high /frequent.

And if your appetite is low / sluggish: To one part of naturally set curd add three parts of room temperature water. Churn well and remove the entire solid fats from it. Season it with salt and pepper.

Buttermilk prepared and consumed by individual body types like this balances their body type, improves appetite, stimulates intestinal enzymes and acids, helps in digestion, destroys intestinal diseases and nourishes the body tissues.

Pranayama For Premenstrual Syndrome

Are you tensed, anxious, irritated, or angry? Does your acne flare up? or do you have diarrhea before your monthly periods? It could be your premenstrual syndrome. Practice chandra naadi pranayama to balance your body and mind before your periods. It lowers your sympathetic neuro stimulation that calms your agitation, fight and flight mode.

On the other hand, if you are depressed, have crying spells, poor concentration, and constipation then practice surya naadi pranayama to balance your mind and body as it stimulates your sympathetic neuro system and alerts your fight and flight mode.