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Essential tests a woman should take annually

March 9 2020 , Written by Ambika

  • Dr. Aparna Dhar, Lead Medical Geneticist and Genetic Counselor, CORE Diagnostics

While, carrying the burden of various roles and their responsibilities – daughter, sister, wife and mother – women a lot of time forget to take care of themselves which at times results in serious medical issues. In some cases, the disease is unpreventable, however, for many of these cases, the situation could have been prevented if the disease was diagnosed at an earlier stage.  

Therefore, there is a dire need to raise awareness about the importance of ‘early diagnosis’ and ‘top diagnostic tests women should definitely undertake annually’ for better and healthier future.

 

Top diagnostic tests that women must take regularly:

 

  1. Pap Smear:

A pap smear looks for signs of cervical cancer to help catch it at an early stage. It looks for precancerous or cancerous cells on your cervix.

Women, starting from the age of 21, should have a Pap smear test done every three years. The interval can be increased as you grow older and have a normal Pap test consecutively.

 

Procedure: During the procedure, cells from your cervix are gently scraped away and examined for abnormal growth. The procedure is done at your doctor’s office. It may be mildly uncomfortable but doesn’t usually cause any long-term pain.

 

  1. Breast Cancer Screening:

Breast Cancer screening includes self-breast exams, mammograms, breast MRIs and X-rays. It looks for signs of breast cancer to diagnose it an early stage.

It is recommended that every woman goes for annual mammograms after the age of 40. Mammography is the process of using low-energy X-rays to examine the human breast for detection of masses. 

 

For women, with a strong family history of breast cancer or an increased risk of breast cancer due to a genetic mutation, should start with annual mammograms and breast MRI scans at the age of 30.

 

A breast self-examination is a way to screen for lumps or any changes in breast to screen for breast cancer at home. You can use your eyes and hands to determine if there are any changes to the look and feel of your breasts.

Every woman can start with breast self-exam at an age of 25 and go for an MRI if you notice something unusual.

 

  1. Cholesterol Check:

A lipid profile test measures level of cholesterol and triglycerides. It helps in assessing your heart disease risk.

 

After the age of 20, every woman should get tested every 3-5 years. For women with an increased risk of developing a heart disease, or have diabetes, should get tested annually.

It consists of blood test which measures levels of HDL, LDL, Total Cholesterol and Triglycerides.

 

In case of high cholesterol/triglycerides levels, you should consult a doctor and consider a change in diet and exercise regime.

 

  1. Blood Glucose Test:

Starting at the age of 45, women should get a blood glucose test every 3 years. It is used to check the level of glucose (sugar) in your blood. Elevated blood sugar levels indicate that the body is not making sufficient amount of insulin. It can be an indication of diabetes or prediabetes.

 

For women with a family history of diabetes, or obesity, should start testing blood sugar levels at an early age, and more frequently.

 

A blood testing for fasting glucose level test or HbA1c could be done. For a fasting blood glucose test, you can't eat or drink anything but water for eight hours before your test.

Whereas, HbA1c looks for an average of your blood sugar over the last three months and does not require fasting.

 

If you're in the borderline, prediabetes, lifestyle changes can prevent you from progressing to diabetes. Eating a healthy diet, losing weight, and regular exercise can decrease your risk of getting type 2 diabetes.

 

  1. TSH (Thyroid-stimulating hormone) and T4 test:

The thyroid is a gland in the neck that produces hormones that regulate metabolism. Women are more likely than men to have an underactive thyroid gland (hypothyroidism) or overactive thyroid gland (hyperthyroidism).

 

The TSH and T4 tests is a blood test which measures hormone levels to make sure your thyroid is working correctly.

 

Women after the age of 60, should regularly test for TSH and T4 levels. If there are symptoms like fatigue, muscle weakness, weight gain/loss etc., a test should be done at an earlier stage.

 

The test result could indicate normal, hypothyroidism (insufficient thyroid hormones), or hyperthyroidism (overactive thyroid).

Hypothyroidism is treated with synthetic thyroid hormone taken daily by mouth. Hyperthyroidism is treated with radioactive iodine, anti-thyroid medicine, or surgery.

 

*Please note that according to the brand guidelines, the company name is to be written as ‘CORE Diagnostics

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ABSENT-MINDED CRACKING CAN LEAD TO PROBLEMS IN THE LONG RUN Dr. Ravichandra Kelkar, Consultant Orthopedics, Columbia Asia Hospital Hebbal

November 29 2019 , Written by Ambika

It is surprising sometimes how are small little but ignorant habits can be a cause of major health concern for our body in the longer run. One such habit that many people do almost absent-mindedly is that of cracking their knuckles. Studies have shown that as many as 54 percent of people crack their knuckles.

 

Some of the reasons due to which people tend to do so include:

  • Some people are just fond of the sound that knuckle cracking produces, even while they are not aware about the same.
  • Certain other like the way it feels. Some are under the belief that cracking of knuckles makes more room in the joint, relieving tension and increasing mobility. There is no medical evidence if cracking actually does that.
  • When nervousness or stress shoots into some people, they tend to turn to cracking their knuckles.
  • It becomes an unconscious habit which does not demand much of efforts.

HOW DOES THE SOUND OCCUR?

There are not very specific reasons known for the pop sound that comes when the knuckles are cracked. Some attribute it to the nitrogen bubbles either forming or collapsing in the joint fluid, while others believe it comes from movement of the ligaments around the knuckle. The tendons or muscles moving over the joint can also cause the sound.

 

CRACKING SIDE EFFECTS

There are no major concerns surrounding the knuckle cracking. However, if the cracking is painful, leads to swelling or changes the shape of the joint then it can be a cause of worry as it may be due to underlying gout or arthritis.

In rare scenarios, there are also chances of the finger being pulled out of the joint or the ligaments around the joint being injured.

 

WHEN TO VISIT A DOCTOR?

As stated above as long as there is no pain or swelling or change in the joint shape, there is not a reason to worry. But if any of these signs show up or if your finger looks crooked or swollen, then one must get it evaluated by the doctor. The pain or swelling in the joints is usually due to an underlying condition and should be checked.

Usually the noises coming from the joints are not a worrisome symptom but if that persists over a long period of time with pain, then it could be a problem.

 

Cracking or popping accompanied with pain or swelling could also be a sign of:
Meniscus tears: The meniscus is a rubbery C-shaped disc that cushions the knee and absorbs shock but twisting or other sudden harsh movements can sometimes lead to its tear.


Cartilage wear or injury: The cartilage covering the bones can sometimes get injured and result in breaking off of a piece and a catch in the joint.

 

ARE CRACKING JOINTS RELATED TO ARTHRITIS?

In a usual scenario, cracking or popping neither damages the joints, nor symbolizes initial arthritis stages. But sometimes a worn cartilage in the joints or the rubbing of bones together can cause pain.

 

However, if a person has pre-existing conditions like arthritis or other bone/joint related health conditions then they are suggested to avoid cracking their knuckles. People with weak bones should also not get into the cracking habit. Repetitive cracking can potentially become a botheration of we are not aware and informed. Cracking has also been observed to be socially annoying and a negative distraction for people around you. Some tips that can be used to break the cracking habit are:

  • Be observant and notice when or why you are likely to knuckle. Address that cause to avoid knuckling in a similar scenario next time.
  • If stress is resulting in cracking for you then come with alternatives for yourself to relieve that stress through deep breathing, exercise, or meditation.
  • If you tend to crack too frequently and mostly due to nervousness or stress, then keep a stress ball or worry stone near you to be squeezed or rubbed respectively when the situation arises.
  • When the habit is too rooted, some people also suggest wearing a rubber band on the wrist and snapping it every time one is about to crack the knuckles.
  • Stay aware of yourself and consciously make the efforts for your desired results.
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CARDIAC TAMPONADE: A FATAL CONDITION THAT MOST DON’T KNOW ABOUT

November 5 2019 , Written by Ambika

Dr. Mohan Kumar HN, Consultant – Interventional Cardiologist, Columbia Asia Hospital Sarjapur Road

 

 

We all know that our heart is the most significant yet the most sensitive organ of our body. It goes without saying that our heart hence requires special attention and care. Reasons, both external as well as internal can affect our heart. While the lifestyle being lived these days has thrown enough light on the concerns related to heart like cardiac arrest, heart failure, heart attack, etc. There still remains one very serious medical condition that is not a result of the lifestyle choices really but is something grave enough to be known about. The condition being referred to here is called cardiac tamponade. To put it simply, it is the compression of the heart due to a fluid being collected in the sac that surrounds the heart. This thin, double-walled sac around the heart is called pericardium.

 

How it occurs?

There is a sac that encloses the heart and the heart muscle. When the space between that sac (pericardium) gets filled with blood or fluids, it results in cardiac tamponade which is a serious medical condition. The filling with the fluid creates a lot of pressure on the heart and the pressure in turn, does not allow the ventricles of the heart to expand completely and hence does not let the heart function properly.

The cavity around the heart can fill with bodily fluids or blood enough to compress the heart. As the fluid presses on the heart, it becomes more and more difficult for the blood to enter the heart. Naturally, the amount of blood reaching the heart reduces.

As a result, less oxygen-rich blood gets pumped to the rest of the body or the heart is unable to pump blood adequately to the rest of the body which can eventually result in organ failure, shock, and cardiac arrest or can even be fatal.

 

Some of the causes that can create such a situation are:

·It is generally the result of penetration of the pericardium that causes cardiac tamponade. Some of the causes of pericardial penetration or fluid accumulation can be:

·Wounds from a stab or gunshot

·Explicit trauma to the chest due to a car or industrial accident

·Perforation that can happen accidentally after cardiac catheterization, angiography, or insertion of a pacemaker

·Punctures made during placement of a central line

·Breast or lung cancer that might spread to the pericardial sac

·A ruptured aortic aneurysm

·Pericarditis, an inflammation disease in which the immune system by mistake attacks healthy tissues

·Chest extremely exposed to radiation

·Hypothyroidism

·Heart attack

·Kidney failure

·Other infections that are likely to affect the heart

 

Since cardiac tamponade is a serious medical condition that can even be fatal, it is important to watch out for the likely symptoms some of which include:

·Restlessness and anxiety

·Low blood pressure

·Weakness

·Chest pain radiating to your neck, shoulders, or back

·Difficulty in breathing or taking deep breaths

·Fast breathing

·Discomfort that’s relieved by sitting or leaning forward

·Dizziness and loss of consciousness

 

Once you observe any of the symptoms, you should seek medical help at the earliest. The diagnosis of cardiac tamponade usually consists of three signs that a doctor recognizes, which are also called as Beck’s triad. These signs include:

·Low blood pressure and weak pulse as the volume of the blood being pumped by the heart gets reduced.

·Extended neck veins due to the difficulty they experience in returning blood to the heart.

·A rapid heartbeat along with muffled heart sounds because of the increasing layer of fluid inside the pericardium.

 

Some other diagnostic tests like an echocardiogram, a thoracic CT scan, a magnetic resonance imaging are also done after the above observations to confirm a cardiac tamponade.

However, once diagnosed, cardiac tamponade needs hospital immediate hospitalization and emergency invasive treatment to relieve  pressure on the heart before treating the underlying condition. The patient needs to be stabilized too before the procedures are undertaken. 

 

 

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Fungal Infections of the Skin and its Resistance – A Rising Menace

September 27 2019 , Written by Ambika

 Contributed by Dr Thansiha, Consultant Dermatology Venereology Leprosy , Aster RV Hospital.

Skin is the one of the most abused organ of our body. The appearance of small rash is just taken lightly and usually treated by over the counter medications by patients from pharmacies or by home remedies. Though every skin disease is not life threatening , appropriate treatment from a dermatologist ensures better quality of life in terms of disease control and itching.

 

How does fungal infection of the skin present? 

Fungal infection of the skin is commonly referred to as ringworm. Skin fungal infection is not a major disease but its inappropriate treatment makes it a major one as it affects your daily life. People suffering from these infections have extreme itching mostly at night and have red colour patches in covered areas of the body especially groin. It can also present as changes in the nail colour or even as patch of hair loss.

 

Why are fungal infections of the skin on a rise?

In the recent years, dermatologists have been facing an alarming issue in their clinical practice due to an increase in the fungal infections of the skin. It usually starts with one family member and then progresses to involve other family members due to close contact, bad personal hygiene and inappropriate use of over the counter medications. It can spread from one person to other either by direct contact with infected person / by sharing of objects of daily use. The over the counter medications which give an initial relief are usually a combination of drugs that include topical steroids that inadvertently harm the skin. The rampant usage of topical steroids has increased the spread of the disease and has made it an epidemic.

 

What is fungal resistance? 

Inadequate usage of antifungal medications (creams/ tablets) in terms of dosage or duration can lead to development of resistance to drugs. Skin fungal infections usually need at least one- two months of treatment. Most patients stop the drug abruptly once the disease comes down or do not want to take treatment for the prescribed time. When the drug is stopped abruptly and not taken according to the recommended course, the infection comes back within no time. The recurrence of infections usually needs to be treated with a higher dosage or longer duration of antifungal. Sometimes disease is so resistant that even 6 months of treatment is insufficient to eradicate the fungus from the body. The various factors that can contribute to recurrences include inadequate treatment, improper adherence to treatment, improper or inadequate treatment of close contacts or family members, resistance to antifungal drugs, use of topical steroid antifungals and self-medication.

 

What is the need of the hour with respect to fungal infections of the skin?

Avoid self-medication. It is not advisable to buy medicines/ creams over the counter / as advised by the family members / neighbo

 

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Self-care and Frequent movement to Thaw the Frozen Shoulder

September 19 2019 , Written by Ambika

Dr. Shankar Kurpad, Consultant Orthopedics, Columbia Asia Referral Hospital Yeshwanthpur

 

The normal shoulder is one of the most mobile joints, and permits us to place our hands where we need it, and helps us make the master of the environment that we live in.

 

One of the common problems that are being faced these days by many people is that of a frozen shoulder. Frozen shoulder is referred to the condition in which the shoulder joint becomes painful, and develops stiffness gradually over time.

The Shoulder Joint is a complex ball-and-socket joint where the ball shaped upper end of the arm bone (humerus) articulates with the cup shaped socket in the shoulder blade (scapula).  Strong connective tissue, called the shoulder capsule, surrounds the ball and socket joint. The capsule and ligaments surrounding the shoulder joint holds the bones together and permits movements is a safe manner. The muscles around the shoulder help move it in such a beautiful and well-coordinated manner. The capsule is lined with special cells that make the joint fluid, that lubricates the joint, keeping the movements friction free and smooth.

Frozen shoulder is thought to be a result of inflammation of the shoulder join

t capsule, resulting in stiffening of the shoulder. The shoulder joint capsule becomes thickened and stiff. The shoulder becomes very painful and movements at the shoulder become reduced over time.

The inflammatory process in the shoulder may be triggered off by a minor illness such as a viral fever, a trivial injury to the shoulder, or sometimes situations where the shoulder was left immobile for some time. This painful and stiff shoulder problem is more common in Diabetics, although it is not clear as to why Diabetes makes our shoulders more susceptible to this inflammatory process. The long working hours, irregular dietary habits, stressful and sedentary lifestyle along with lack of regular exercise is often blamed for leading onto such problems. Most often Frozen shoulder is seen in people older than 40 years, however, the problem is gradually becoming more common in younger people. This urges us to try and prevent such problems.

 

The symptoms of a frozen shoulder are dull aching shoulder pain, with the patient complaining of severe pain with shoulder movements. Over time, it is noticed that the movements at the shoulder gradually become reduced. Often, the pain is worse during the night, disturbing sleep.

 

Frozen shoulder usually progresses through stages:

·Freezing stage: This is when any movement in the shoulder initiates pain and the shoulder’s range of motion gradually becomes limited.

·Frozen stage: Even though the constant dull pain may reduce, the shoulder becomes stiffer and extremely difficult to move.

·Thawing stage: This is when the limit of the shoulder’s motion starts improving

It can take a year to three years or so for a frozen shoulder to go through these stages and resolve.

While frozen shoulder can be severely painful and disrupting, becoming a hurdle in everyday routine activities, it is something that can be resolved with a few simple steps, most of which involves self-care. 

 

Diagnosis & Investigations

The diagnosis is most often made based on a detailed evaluation of the patient & clinical examination. Your orthopaedic surgeon may sometimes take an X-Ray to rule out other potential problems that may cause a painful, stiff shoulder. Sometimes, an MRI is used to evaluate the shoulder in greater detail.

 

Preventive measures

For any other reason, such as after an illness, or an injury to that upper limb, due to which the shoulder movements are reduced may lead onto a frozen shoulder. Early active mobilisation of the shoulder would help prevent the onset of this problem.

In people who are diabetic, and those with hyperthyroidism or hypothyroidism, it is recommended to seek treatment to maintain these conditions under good control. This is thought to reduce the chances of frozen shoulder.

 

Remedies for a frozen shoulder:

*Lifestyle plays a major role in deciding the severety of frozen shoulder and the time it takes to heal. Maintaining good control on Diabetes, thyroid problems if present, is thought to help hasten recovery.

*Actively use the involved shoulder frequently as much as possible to eventually improve the pain and range-of-motion. However, it is recommended to avoid heavy weights & strenuous use of the shoulder.

*Warm packs or Ice packs can also be applied to relieve the shoulder pain. Warm water fomentation is commonly used to reduce pain & permit more movement at the shoulder.

*A visit to the Orthopaedic Surgeon to confirm the diagnosis, and then work with the  physiotherapist to learn range-of-motion exercises goes a long way in bringing this shoulder back to its normal self. These exercises will aid in recovering the mobility in the shoulder to a large extent. The patient can choose to regularly visit the therapist for exercises or learn them and consistently follow up at home with discipline.

*With determination, self-care and regular exercises, there is gradual improvement in the shoulder

In more severe painful shoulders, the following may help:

*The initial pain and inflammation can also be reduced with certain regular pain relievers but, it is always advised to take it after consulting your orthopaedic surgeon.

*Alternative medicines like acupuncture works quite well as if done properly, especially to assist in relieving pain.

*Transcutaneous electrical nerve stimulation (TENS) is also one of the physiotherapy treatments that can help in control of pain.

Occasionally, further treatment may be indicated:

*Steroid injections into the affected shoulder joint to bring down the pain and improve the mobility of the shoulder especially in the early stages.

*Injecting sterile water into the joint capsule is sometimes done to help the tight capsular tissue to stretch, thereby reducing the stiffness and ease movement.

*A shoulder manipulation under anaesthesia might also be done by the orthopaedic surgeon to help regain movements in the shoulder. In this process, the patient is given general anesthesia. and the doctor then moves the joint very carefully in various directions.

*Frozen shoulder requiring surgery is extremely rare. Sometimes, if it does not resolve and X-Rays and MRI scans reveal tight, thickened capsule tissue that is adherent and limits movements. Occasionally, this needs surgical release by arthroscopic surgery to remove adhesions and scar tissue from inside the joint, and assist in restoring movements to the shoulder

 

Key Points:

·Frozen shoulder is a result of a type of inflammation of the shoulder joint capsule, causing thickening of the capsule, making it stiff.

·The shoulder becomes Painful & stiff, with reduced movements.

·Some health conditions may increase chances of this problem – Diabetes, Hypothyroidism

·3 Phases – Freezing à Frozen à Thawing. The whole process takes between 1-3 years.

·Prevent prolonged immobility of the shoulder. Even if the shoulder is rested due to other illness or injury, the shoulder can very often be mobilized within safe limits.

·A few patients may need injections into the shoulder or manipulation under anaesthesia, and very occasionally, some may need arthroscopic surgery

·The vast majority of patients improve with self-help - doing active exercises regularly to restore movements, and physical methods such as ice packs or warm water fomentation to reduce pain.

 

 

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Diabetes and Pregnancy - “The Sweet Scare “

July 16 2019 , Written by Ambika

Contributed by Dr. Manjunath Malige ‘Clinical Lead and Senior Endocrinologist’ Aster RV Hospital

 

 

Pregnancy can be a time of excitement and anticipation but few women may experience health problems during pregnancy. These complications can involve the mother's health and the baby health leading to a high-risk pregnancy.

 

Diabetes is the most common medical complication during pregnancy, representing 3.3% of all live births. Diabetes in pregnancy can have serious consequences for the mother and the growing foetus. The severity of problems often depends on the degree of the mother's diabetic disease, especially if she has vascular (blood vessel) complications and poor blood glucose control.

 

Diabetes in pregnancy can occur in two forms:

 

1. Gestational Diabetes Mellitus (also known as Pregnancy Diabetes)

2. Pregnancy in women with Pre-existing Diabetes

 

Gestational Diabetes is a type of Diabetes that affects pregnant women usually during mid to later part of the pregnancy, from fourth month of pregnancy onwards.  It is usually diagnosed through a blood test between 24 – 28 weeks of pregnancy.  Women who had Gestational Diabetes during previous pregnancies may be tested earlier in pregnancy. With good management of Gestational Diabetes with the help of an Endocrinologist one can significantly reduce the risk of complications to both mother and baby and also improve the chances of a normal delivery.

 

What causes Gestational Diabetes:

 

During pregnancy, body produces hormones (chemical messengers) which make it difficult for your body to use the insulin produced thereby creating a state of Insulin Resistance. Insulin is normally required for the body to use glucose in the blood as energy source. With insulin resistance, one’s own insulin struggles to help body use glucose for energy and hence glucose levels in the blood rises leading to Gestational Diabetes.

 

Who is at risk of developing Gestational Diabetes:

 

The following groups of women are at risk ,

 

1.  South Asian, Black or Afro Caribbean and Middle Eastern Ethnicity.

2. Overweight or Obese women

3.Gestational Diabetes in previous pregnancy

4.Having delivered a large baby in previous pregnancy ( 4.5 Kg or more)

5. Family history of Diabetes ( parent, sibling )

 

How to manage Gestational Diabetes :

 

1. Seek Professional help from an Endocrinologist

2.Understand Gestational diabetes and treatment options

3.Buy a blood glucose meter and agree ( with your Doctor ) about blood sugar targets

4. See a Dietitian for advise regarding healthy diet and regular exercise.

5. Understand how to treat low and high blood sugars

6. Have hospital helpline or emergency department numbers to hand

 

Complications of Gestational Diabetes:

 

It is extremely important to control the blood sugars during pregnancy to prevent complications to both mother and baby. Poor control of Diabetes increases the risk of having a large baby making normal delivery difficult, baby can develop malformations of spine, heart and other organs, baby can develop low blood glucose ( Neonatal Hypoglycaemia ), risk of baby dying around time of birth ( Perinatal death), risk of baby developing Diabetes later in life.

 

What is the treatment :

Depending on your initial blood sugars, Endocrinologist may advise Diet and regular exercise to start with. If blood sugars are not controlled tablets may be stated and if this fails to control blood sugars, Insulin injections will be needed.

 

Apart from this, frequent checking of blood sugars will be needed, frequent baby scans will be needed and if blood sugars are not well controlled delivery of the baby may have to brought forward.

 

Management of Diabetes in Diabetic Women who become pregnant is similar to that of Gestational Diabetes, except that it is advisable to get the Diabetes under good control before planning pregnancy and regular eye (Retina) checks will be needed.

 

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Sleepless nights with electric sensation in legs? Check for RESTLESS LEG SYNDROME with your expert

June 21 2019 , Written by Ambika

 

Dr. Anil. R, Consultant – Neurologist, Columbia Asia Hospital, Hebbal

 

Have you ever woken up at night with the strong urge to move your legs or experienced a heaviness in your legs that has been relieved after you tried moving your legs? Well it might not seem a big deal at the instance but if you experience this often, you might be suffering from the restless legs syndrome (RESTLESS LEG SYNDROME), a disorder of the part of nervous system that leads to a severe itch to move or shake one’s legs with usually an unpleasant feeling. This uncomfortable sensation generally tends to occur in the evening or nighttime hours when you are sitting or lying down. While moving your legs might ease out the sensation, it is only a temporary solution. Also known as Willis-Ekbom diseases (WED), restless leg syndrome can initiate at any age and worsen as the person grows and even disrupt sleep and everyday activities. It is also considered as a sleep disorder by some and has been observed more in women than men.

 

 

Symptoms

The major symptom of restless leg syndrome, as the name suggests, is the strong need to move the legs accompanied with an uncomfortable sensation of restlessness in the legs. This sensation usually happens after taking rest or lying down or sitting over a long period of time.

The sensations are usually difficult to explain and tend to vary but usually happens on both sides of the body in the legs. In case of restless leg syndrome, these sensations usually happen within the limb and not in the skin. Some of these sensations are crawling, creeping, pulling, throbbing, aching, itching, electric, etc. The symptoms can fluctuate in their time of occurrence as well as frequency and severity.


Causes

There is no particular cause for restless leg syndrome. Some experts and researchers suspect that an imbalance of dopamine (the brain chemical responsible for sending messages to control muscle movement) can lead to restless leg syndrome.

·Long hours of travel or long movies can also cause this sensation.

·Restless leg syndrome can sometimes also be hereditary especially if it begins before the age of 40. Sites on the chromosomes where genes for restless leg syndrome maybe there have been identified.

·Hormonal changes or pregnancy can also sometimes enhance the signs of the syndrome.

·Women sometimes get restless leg syndrome for the first time during their pregnancy especially in the last trimester.

More often than not, restless leg syndrome is not linked with any other serious underlying medical issues. However, sometimes certain medical conditions such as the following can be accompanied by restless leg syndrome:

 

Peripheral neuropathy that damages the nerves in one’s hands or feet and can occur as a cause of some chronic disease like diabetes and alcoholism.

 

Iron deficiency, even without anemia, can worsen restless leg syndrome. Various reasons like a history of bleeding from stomach or bowels, or heavy menstrual periods can lead to iron deficiency.

 

Kidney failure that often comes with iron deficiency, usually with anemia can lead to changes in the body chemistry and further increase restless leg syndrome. When kidneys do not function properly, the iron stored in the blood can decrease.

 

Spinal cord lesions have also been observed to have a connection with restless leg syndrome. A spinal block, having had anesthesia to the spinal cord can increase the risk of developing restless leg syndrome/wed.

 

Complications

Although restless leg syndrome does not really lead to any major or serious health condition, its symptoms vary and can range from hardly bothering to severely incapacitating.

 

Many a times people with restless leg syndrome find it difficult to get appropriate sleep and hence affect their daily routine activities.

Insomnia can further accelerate excessive daytime drowsiness but restless leg syndrome is likely to interfere with napping.

In turn, severe restless leg syndrome can also cause marked impairment in life quality and can also result in depression.

Restless leg syndrome can also be associated with another common medical condition termed periodic limb movement of sleep and makes one’s legs twitch and kick, mostly all through the night while one is asleep.

 

When to see a doctor

A common worry with restless leg syndrome is often ignorance. Due to the not so severe outcomes or symptoms, it is often not taken as seriously or not even considered as any syndrome by many still. Mostly people never seek for medical advice for this condition but the frequent occurrence of restless leg syndrome can affect the quality of life severely in the longer run.

 

What can be done?

Restless leg syndrome can be take care of with simple self-care steps and lifestyle changes. More than just medications, improving one’s sleeping cycle and increasing the physical activities can help make the condition better. Mild movements such as stretching, jiggling, pacing or walking also help

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How does aging affect the chances of conceiving?

May 30 2019 , Written by Ambika

Dr. Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Columbia Asia Hospital Whitefield

 

 

As the number of women standing tall in various sectors is rising with every passing year, so is the pregnancy age. With more and more women stepping out to pursue their professional interests and become self-dependent, the work-life balance is mostly coming at the cost of delayed family planning.

 

Studies show that the average pregnancy age currently around 28 years and many times is extended up to 35. Some of the reasons for delayed parenthood are:

  • Women reaching higher education levels, establishing their career
  • Social and cultural shifts 
  • Desired financial stability for the child's secured future
  • Lack of childcare
  • Inflexible workplace policies
  • Economic or housing uncertainty

The advancement in medical sector indeed provides with sufficient aid and several ways for women to deliver healthy babies irrespective of age. However, though there isn't any safe age, pregnancy at an early age can save both the mother and the child from several complications. Pregnancy, especially after the age of 35, is likely to come with certain risk factors. It must also be noted that it is not just the maternal age but also the paternal age which plays a role significantly in increased complications. As the trend of late pregnancy looks like it's here to stay, doctors highlight the following as some of the risks involved says Dr. Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Columbia Asia Hospital Whitefield

 

 

Declined number of eggs/sperms

With the increasing age the possibility of women getting pregnant goes down because of the reducing number of remaining eggs and their decreased quality. The eggs in older women may not even fertilize as easily as in younger women. For males as well, the sperm count goes down with age and so does the semen volume and motility. These natural age-related factors add to the difficulty in conceiving for females.

 

Genetic factors

A few genetic risks like that of having a baby with Down syndrome are more probable to occur during pregnancy in women as they age. The chances of other chromosome abnormalities in the baby also increase with age.

 

Multiple pregnancies

With the increasing age, the possibilities of delivering twins also increase due to the release of multiple eggs at the same time. Assisted reproductive technologies are also responsible sometimes.

 

Miscarriage & Stillbirth

The decline in the quality of a woman’s eggs and other co-existing medical conditions possibly create increased chances of miscarriage and stillbirth which are extremely rare but likely.

 

Maternal mortality

Studies conducted have also found that the risk of mortality due to various other complications in the body also increases with the increased age of the pregnant woman.

 

Premature delivery

                                                                                                                                   
Doctors have observed cases of early deliveries when the baby has not completely matured (premature delivery) mostly in women delivering babies in later stages of their lives due to the associated health complications. Babies born pre-mature often have low birth weight, respiratory, cognitive and neurological problems. Preterm babies are more likely to have heart defects, brain damage, lung disorders, and delayed development.

 

Uterus complications

Medical research has also found that with age muscle contraction properties in the uterus were detected to be impaired, reduced sensitivity to oxytocin, and decreased mitochondria numbers. Change in progesterone signaling was also observed that further increases a delay in labor.

 

Cardiovascular problems

The older the woman gets pregnant, the more are the chances of ischemic stroke, hemorrhagic stroke, heart attack and other cardiovascular diseases in the woman which can even be fatal. These risks have enhanced all the more with the kind of lifestyle being lived these days.

 

Other health problems

It has been well established that as the age increases, the possibility of having health problems also increases especially in the current lifestyle. Hence late pregnancy increases the risk of issues like gestational diabetes, high blood pressure, emergency cesarean delivery, postpartum hemorrhage, pre-term birth, low birth weight, and high birth weight.

 

Late pregnancies with completely healthy births and minimum complications are possible as well.

 

 

Following are few tips that women conceiving in the later age can keep in mind for a healthier pregnancy and delivery:

·First and foremost, take good care of yourself and pay heed to the basics.

·Go for preconception appointments; be aware of your overall health and lifestyle changes

·Pursue prenatal care regularly

·Stay in constant touch with your health care provider and discuss all details and concerns

·Maintain a healthy diet with the sufficient amount of folic acid, calcium, iron, vitamin D and other nutrients required in your body after discussion with your doctor

·Stay active with regular exercise

·Avoid substances like alcohol, tobacco, etc.

·Manage pre-existing conditions like diabetes, blood pressure, anemia and thyroid disorders etc. to avoid comorbidity

 

 

 

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Keep your movement game up to avoid blood clotting in your deep veins

April 30 2019 , Written by Ambika

Dr. Krishna Chaitanya K H, Consultant Vascular Surgery, Columbia Asia Hospital Hebbal

 

While information and awareness has been a boon, it has also increased the health problems that people are suffering from without even knowing about them enough. The increasing availability of information is not only adding to the list of solutions but also enhancing the problems, especially in the health sector.

One such problem is a deep vein thrombosis, also referred to as DVT. A thrombosis is basically the clotting of the blood. When a blood clot develops in the deep veins specially the ones located in the arm or leg, it is likely to lead to Deep Veins Thrombosis.

Blood clots in the superficial veins are not as dangerous as those in the deep ones owing to the life-threatening complications attached with them. A thrombus (blood clot) in the deep veins of the leg is significantly dangerous if a part of the clot breaks off or travels through the blood stream, the heart and into the pulmonary arteries forming a pulmonary embolism, which is the condition when an artery or more going from the heart to the lungs are blocked by a blood clot.

Broken bones, immobility, limb trauma, cancer, smoking, certain medications, genetic predisposition are among the causes that can lead to DVT.

Signs or symptoms of a small pulmonary embolism (blood clot in the lungs) may not be present very evidently in a person but a large embolism can be fatal too. Almost half of the people with DVT do not even receive the warning signs. The most common clinical scenario of DVT is a leg swollen below the knee. Some common symptoms of Deep Veins Thrombosis in the leg are:

·Pain specifically in the area of the clot

·Swelling

·Tenderness

·Warmth

·Redness of the leg or arm depending on where the clot has occurred

Experts say however rare it might be, the problem should be adhered to without any delay.

Any damage to the inner lining of a vein can lead to Deep Veins Thrombosis, be it due to surgery, an injury, or the immune system. A thick and slow flowing blood is more likely to form a clot, especially in an already damaged vein.

People with more estrogen in their system and those having some genetic disorders are more likely to develop blood clots. The DVT clot tends to move into the lungs and block the supply of blood causing trouble in breathing, low blood pressure, faster heart rate, chest pain, instances of fainting and coughing of blood, all of which require urgent medical aid.

 

Major risk factors that can lead to a blood clot formation and result in DVT are:

·Immobility

·Genetic tendency towards clotting of blood

·Injury to the veins or adjacent tissues

This leaves certain following people more at the risk of getting DVT:

·Those having cancer

·Those who have had any surgery or are on extended bed rest

·Older people

·Smokers

·Obese or overweight people

·Those who sit for long extended hours or traveling in long-duration flights that lead to lack of movement, affecting blood flow

·Pregnant women: During pregnancy or in the 4 to 6 weeks of giving birth, women are more prone to develop DVT owing to the higher levels of estrogen which eases the formation of a blood clot. Their blood flow in the veins also slows down due to the pressure of their expanding uterus. Some blood disorders also enhance risk.

Another serious concern that comes with DVT is its associated long-term effects, even after the blood clot has been dissolved, at times even as much as a year after the clot. Following are some post-thrombotic syndrome:

·long-term swelling

·changes in the color of the skin where the clot was

·pain

It becomes important to understand body function and internal details to know the reasons, occurrence and the danger extent of the blood clots. A little awareness and some small steps regularly in the daily routines combined with the conscious efforts for one’s own better health can prevent from the many serious problems.

 

Some of the tips to keep away DVT are:

Exercise regularly: This point cannot be stressed enough especially in the current scenario of lifestyle problems. The more regularly you exercise and use your muscles; the better is the blood flow. For DVT specifically, work your lower leg muscles. Walking soon after a surgery also reduces the risk of a clot and of chronic swelling in the legs from the post-thrombotic syndrome.

 

Travel advice: When travelling for long duration that requires you to be seated, wear lose clothes, drink lots of water, try to walk around every couple of hours, stretch and move your legs while sitting as well like clenching and releasing calves and thighs or lifting or lowering the heels with toes on the floor.

 

Feet Up: When possible, sit with your feet off the floor, raising your legs to ease the blood flow in your veins up to your heart o reduce the swelling and discomfort in the DVT leg.

 

Compression Stockings: These are specially designed to put gentle pressure on your legs to keep the blood moving, avoid clot formations, keep the swelling down, and decrease the pain. However, these are suggested to be used after prescription.

 

Clot Busters: These are certain medicines in the name of thrombolytic that dissolve blood. But these are only to be used in emergencies when for instance; there is a life-threatening clot in your lung.

 

Blood Thinners: These also must be used under a doctor's guidance as there are too many side effects. Blood thinners are drugs called anticoagulants that are quite common for treating DVT as they make the blood less sticky to prevent from new clots and give time to the body to dissolve the clot on its own.

 

 

 

 

 

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Managing and Coping with Hemophilia

April 17 2019 , Written by Ambika

Dr. Satish Kumar A, Consultant – Oncology, Columbia Asia Referral Hospital Yeshwanthpur

 

Every year 17th April is recognized as World Hemophilia Day to increase awareness about hemophilia and other inherited bleeding disorders, as well as to improve access to care and treatment.  Hemophilia is an inherited disorder where the blood does not clot normally as it should. This disorder is because of a defect in one of the clotting factor genes on the ‘X’ chromosome.

 

What is hemophilia?

Hemophilia is an inherited bleeding problem, where those affected do not bleed faster than normal, but they can bleed for a longer time. Their blood does not have enough clotting factor which is a protein in blood that controls bleeding.

 

Types of hemophilia

·Hemophilia A is the most common type of hemophilia. This means the person does not have enough clotting factor VIII (factor eight).

·Hemophilia B is less common. Here the person does not have enough factor IX (factor nine). In both hemophilia A and B patient’s bleed for a longer time than normal.

 

Degrees of hemophilia

·Severe hemophilia: sufferers usually bleed frequently (one to two times a week) into their muscles or joints. Bleeding is often spontaneous, which means it happens for no obvious reason.

·Moderate hemophilia: patients bleed less frequently (about once a month), and may bleed for a long time after surgery, a bad injury, or dental work. They will rarely experience spontaneous bleeding.

·People with mild hemophilia usually bleed as a result of surgery or major injury. They do not bleed often and some may never show symptoms.

 

The signs of hemophilia A and B are the same:

·Big bruises

·Bleeding into muscles and joints

·Spontaneous bleeding (sudden bleeding inside the body for no clear reason)

·Prolonged bleeding after getting a cut, removing a tooth, or having surgery

·Bleeding for a long time after an accident, especially after an injury to the head

 

Bleeding into a joint or muscle causes:

·Swelling

·Pain and stiffness

·Difficulty using a joint or muscle

Where does bleeding occur?

Excessive bleeding and bruises are the main symptoms of Hemophilia. People with hemophilia commonly have internal bleeding, into muscles or joints. The most common muscle bleeds occur in the muscles of the upper arm and forearm, the iliopsoas muscle (the front of the groin area), the thigh, and the calf. The joints that are most often affected are the knee, ankle, and elbow.

Repeated bleeding into the same joint can lead to pain, permanent damage and arthritis, so walking is often affected. However, the joints of the hands are not usually affected in hemophilia said Dr. Satish Kumar A, Consultant – Oncology, Columbia Asia Referral Hospital Yeshwanthpur.

How is hemophilia diagnosed?

Hemophilia is diagnosed by taking a blood sample and measuring the level of factor activity in the blood. Hemophilia A is diagnosed by testing the level of factor VIII activity. Hemophilia B is diagnosed by measuring the level of factor IX activity.

If the mother is a known carrier of hemophilia, testing can be done before a baby is born. Prenatal diagnosis can be done at 9 to 11 weeks by chorionic villus sampling (CVS) or by fetal blood sampling at a later stage (18 or more weeks).

Treatment

The missing clotting factor is injected into the bloodstream using a needle. Bleeding stops when enough clotting factor reaches the spot that is bleeding.

Bleeding should be treated as quickly as possible. Quick treatment will help reduce pain and damage to the joints, muscles, and organs. If bleeding is treated quickly, less factor is needed to stop the bleeding.

With an adequate quantity of treatment products and proper care, people with hemophilia can live perfectly healthy lives.

 

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