Why menopause occurs?
Yes, menopause occurs as a result of cessation of estrogen activity, but why estrogen activity comes to a halt?
The answer for this is, there are a limited number of ova, which produce estrogens in the female body. A 20-week-old female fetus has as many as 6-7 million ova in their body but at the time of delivery of the female, there are only about 1-2 million remains. This is because of normal physiological ageing. By ageing it does not mean that the baby has aged, but that age-related changes starts even in them. At the time of menarche only 200,000-400,000 ova remain in the ovaries. The others die a natural death during these years. Out of remaining these, only about 400-500 ova will grow to maturity and be released at the time of ovulation. By the time menopause occurs, most of these usually exhaust. The ovary itself develops a shrunken appearance and ovaries cease to produce further estrogen and climacteric followed by menopause sets in. Meager amounts of estrogen continue to be released from other organs like adrenals but these compensate to a limited extent only.
Treatment of menopause and Climacteric symptoms:
It is essential to move toward menopause with a positive attitude. Menopause does not mean the end of life, on the contrary, here starts a new and dynamic phase of a woman's life. It is that stage in a woman's life when she is liberated from the stresses and anxieties of middle age. Her children are adult and settled. She finds more time and space for herself and can take pleasure in both work and leisure. This is the time when she can make use of her talent to the maximum. Many women find sex more enjoyable after menopause as they are no longer concerned about unwanted pregnancies. At times, if sex is painful due to dryness, lubricating jelly ( KY jelly) solves the problem. Sometimes, escape ovulation occur after menopause, though rare, sometimes pregnancy occurs.
Itching of the vulva as sometimes thought, is not a symptom of menopause but dryness is. If there is Itching or heavy discharge, gynaecological checkup is needed to rule out underlying infection-of the lower genital tract.
Regular exercise is required at all stages of life, especially after menopause. Exercise keeps body weight under control, increases basal metabolic rate, which leads to faster burning up of calories, enhances deposition of calcium in the bones and guards the heart from coronary arterial disease. It also offers a feel of wellbeing because of release of certain hormones known as endorphins in the body.
Diet has to be given due attention. A well balanced diet, with plenty of fruits and vegetables will give the body with vitamins, fiber, minerals, and antioxidants, all of which are essential to the body. It is very easy to get obese after menopause, so one should keep the total calorie intake under control and reduce the intake of fats. Vitamins and calcium supplements is essential particularly at this time.
Hormonal Replacement Therapy (HRT)
HRT, as hormonal replacement is popularly known, is the low dose estrogen either synthetic or in natural form is used in the management of climacteric and menopausal symptoms. As most of the symptoms of climacteric can be attributed to estrogen deficiency and compensatory over activity of certain pituitary hormones, administration of estrogen as supplement relieves most of the symptoms in a majority of women.
Arguments and studies are still going on regarding the safety of HRT, but this greatly improves the quality of life. Any deleterious effect like increased incidence of breast carcinoma, heat attacks or endometrial carcinoma is not yet proved convincingly. However, HRT should be started with proper baseline investigations.
There are so many routes and methods one can have estrogen replacement or HRT. It can be given orally as pill, patch in the skin, vaginally as gel. The consulting gynecologist is the best judge to chose which form the woman needs. Those women are having their uterus intact has to take progesterone sequentially to protect the endometrium from cancer.
Most of the irritating symptoms revert following HRT. Bone density improves. Libido increases with elevated mood and disappearance of vaginal dryness. Slightest chance of being pregnant is eliminated.
My personal view is, when HRT improves the quality to a great extant and nothing is proved beyond doubt about its side effects and even if it is there, percentage is so little, the woman should live life with joy by taking HRT, if she agrees after informed counseling.
Tibolone, another drug claims to give all the good effects without the deleterious effects on heart, blood vessels, breast tissue, and endometrium works fine in some but not all women.
Natural food extract capsules like soya extracts with the helpful isoflavones, vitamin E are absolutely safe and help some but not all the women with menopausal syndrome.
This article is also published at India study Channel
Saturday, February 28, 2009
Friday, February 27, 2009
What are the changes expected during cessation of menstruation or, menopause.
What is menopause?
Menopause is the pause of the monthly menstrual flow. It can happen all of a sudden, but it is more usual for menopause to happen gradually. That is to say, the amount of bleeding starts diminishing and the interval between bleeding episodes keeps on rising over the months, till it finally comes to an end.
The average age at which women experience menopause ranges from 45-52 years. There is actually a wide deviation in the age at which menopause occurs, depending on the weather, degree of nutrition, obesity and socio-economic status. Family history also has to be taken into account Women who have menopause in their early or mid-forties find that their mothers had an early menopause too. Obese women often have a late menopause, around the age of 55 years. If menopause occurs before the age of 40, it is diagnosed as premature menopause.
Climacteric is the period just prior to menopause, when symptoms first start to emerge, and it continues till the postmenopausal period, i.e. when one has completed a full year without having another period. It is just the reverse of puberty changes, just as menopause is the reverse of menarche changes. Basically, climacteric is the intermediary phase of 1-5 years during which the genital organs involute as a result of stoppage of ovarian activity. Menopause is only a expression of climacteric, and precedes complete stoppage of ovarian functions by a few months to a few years.
In 50 per cent of all women, the changes of climacteric are for the time being deferred by a slight amount of oestrogen from the adrenal gland.
Ultimately the following changes are seen:
Changes of climacteric, which can be seen outside (Physical Changes)
Changes seen in the skin during climacteric / menopause:
Slowly the skin becomes drier than earlier. There is also a loss of tissue from below the skin ensuing in a loss of elasticity and leading to the emergence of wrinkles. Greater than before facial hair is another indication of menopause.
Urge for sex or, libido diminishes after menopause:
The urge for sex declines as vaginal dryness causes painful penetration. Psychological alterations caused by menopause also influence the sex drive. Women may feel unloved, unattractive and surplus, and may pull out into themselves rather than face rejection. Menopause is the time when it is of utmost importance for both partners to be truthful and unrestrained with each other.
From the medical point of view, the decrease in sex drive is due to a decline in the circulating testosterone levels. Testosterone is the male hormone, and though readers will find it amazing, all women have testosterones circulating in their blood stream! This testosterone is responsible for the sex drive. Menopause with its associated decline in ovarian activity results in a fall in the testosterone level as well. This to a great extent affects the sex urge.
The sex organs atrophy with the menopause:
The vulval skin becomes slender and shiny, and prone to trauma. Subcutaneous fat of the vulva diminishes in amount. Both the labia minora reduce in size and be inclined to disappear. The opening of the vagina gets smaller and loses its elasticity. Later on, pubic hair becomes meager and scarce.
The vagina becomes 'tent shaped' and undergoes contracture in length and width. But those continue sexual activities these chane may not appear. The uterus and cervix become small. The ovaries become atrophied and dried-up in appearance. Breasts get shriveled and tend to become flat, with the exception of in obese women, where they remain large and pendulous. This is because shrinkage is due to the glandular tissue only; fats in the breast and obese women have them in abundance.
Getting overweight after menopause:
Gaining weight is frequent at climacteric but not always, as is generally supposed. When occurs, it is associated to excessive eating to combat emotional stress, and also to change in metabolism. BMR falls significantly after the menopause, while the lady continues to eat the same amount and starts putting on weight.
Changes in heart and blood vessels after menopause:
Women at menopause may have symptoms like palpitation and occasional chest pain related to heart. But the most important symptom of menopause is 'hot flushes'. Flushing of the face and neck may be accompanied by profuse sweating particularly in the night when she reclines leading to night sweats. The basic reason of hot flushes is a increase in the pituitary hormone levels due to lowered circulating estrogen. The duration of a hot flush may vary from half a minute to several minutes. Too much drinking of alcohol, stress, anxiety, heat, or emotional outbursts may all set off a hot flush, but usually hot flushes take place without any precipitating factor.
The level of uneasiness experienced during hot flushes is variable. In some it may be so severe that pillows and bed linens are soaked due to sweat, others may just feel that they have had a disturbed night, and may vaguely remember feeling uncomfortably hot. Most women fall in between these extreme ranges. Insomnia is a natural result of hot flushes. Even if there is no sleep disturbance, there is a feeling of being neglected, dismay, downhearted and depressed. This fact is due to vasodilatation - dilatation of the peripheral blood vessels as a result of hormonal imbalance.
The frequency of coronary arterial disease is more after menopause. Estrogens have a shielding effect on the heart. At menopause, this protection is lost. Blood pressure also tends to rise.
Bones weaken and joint starts paining after menopause:
At menopause, pain in the joints and weakness of bones is also frequent. Bones become frail with the loss of calcium deposits. Increased intake of calcium containing foods such as milk and some green vegetables, along with regular exercise, can help to avert osteoporosis. It has been undoubtedly proved that bone density diminishes after menopause.
Women who have had an early menopause, whose ovaries are surgically removed during hysterectomy, or who suffers from anorexia are at elevated risk of acquiring osteoporosis. Most women have maximum bone density when they are in their thirties, after which bone mass starts declining. Minor traumas result in fractures. Hip, spine and wrist are the most susceptible. At least 1000 mg of calcium supplement along with Vitamin D is recommended daily.
Digestion problem and menopause:
Dyspepsia, indigestion, constipation and abdominal distension of varying degree may also occur during and after menopause.
Psychological Changes following menopause:
Being a major change from all aspects, menopause is viewed with uneasiness by most women. The fright of losing one's womanliness, appearing unpleasant to one's partner or acquiring cancer are very real at this stage. At menopause, women comprehend that their reproductive capacity is lost. Some wrongly regards this is an end of sexual activity and the herald of old age.
For these facts, variety if neurotic and psychotic changes occurs. Depression, irritability, mood swings, irrational behavior, nervousness, tingling or burning in the hands and feet are all common symptoms. Though some of these symptoms are related to the withdrawal of estrogen too as they sometimes disappear after giving HRT or, hormone replacement therapy. Melancholia, leading to suicidal attempts, though rare but may occur in women who have a background of mental instability.
Menopause is just the reverse of menarche. It can be turbulent and annoying for some women. Others seem to sail through menopause smoothly and gracefully. Mood swings usually last for a year or two, and then taper away gradually.
Depression is seen quite commonly in postmenopausal women, and the reasons are multifarious. A sudden drop in estrogens is probably the major cause of depression. It may also be aided by disturbed sleep, gaining weight, or feeling of chronic fatigue. This phase of life is associated with changes in the family dynamics also. Children grow up and leave home and there may be deaths in the family or extra burdens in the form of ageing parents who need care. All these can cause energy loss and thereby depression.
It is essential for the spouse to understand that menopause itself is not a disease, and the menopausal woman is not a neurotic annoyance. An thoughtful spouse can make this complex phase of changeover very simple and smooth.
This article is also published in India Study Channel
Menopause is the pause of the monthly menstrual flow. It can happen all of a sudden, but it is more usual for menopause to happen gradually. That is to say, the amount of bleeding starts diminishing and the interval between bleeding episodes keeps on rising over the months, till it finally comes to an end.
The average age at which women experience menopause ranges from 45-52 years. There is actually a wide deviation in the age at which menopause occurs, depending on the weather, degree of nutrition, obesity and socio-economic status. Family history also has to be taken into account Women who have menopause in their early or mid-forties find that their mothers had an early menopause too. Obese women often have a late menopause, around the age of 55 years. If menopause occurs before the age of 40, it is diagnosed as premature menopause.
Climacteric is the period just prior to menopause, when symptoms first start to emerge, and it continues till the postmenopausal period, i.e. when one has completed a full year without having another period. It is just the reverse of puberty changes, just as menopause is the reverse of menarche changes. Basically, climacteric is the intermediary phase of 1-5 years during which the genital organs involute as a result of stoppage of ovarian activity. Menopause is only a expression of climacteric, and precedes complete stoppage of ovarian functions by a few months to a few years.
In 50 per cent of all women, the changes of climacteric are for the time being deferred by a slight amount of oestrogen from the adrenal gland.
Ultimately the following changes are seen:
Changes of climacteric, which can be seen outside (Physical Changes)
Changes seen in the skin during climacteric / menopause:
Slowly the skin becomes drier than earlier. There is also a loss of tissue from below the skin ensuing in a loss of elasticity and leading to the emergence of wrinkles. Greater than before facial hair is another indication of menopause.
Urge for sex or, libido diminishes after menopause:
The urge for sex declines as vaginal dryness causes painful penetration. Psychological alterations caused by menopause also influence the sex drive. Women may feel unloved, unattractive and surplus, and may pull out into themselves rather than face rejection. Menopause is the time when it is of utmost importance for both partners to be truthful and unrestrained with each other.
From the medical point of view, the decrease in sex drive is due to a decline in the circulating testosterone levels. Testosterone is the male hormone, and though readers will find it amazing, all women have testosterones circulating in their blood stream! This testosterone is responsible for the sex drive. Menopause with its associated decline in ovarian activity results in a fall in the testosterone level as well. This to a great extent affects the sex urge.
The sex organs atrophy with the menopause:
The vulval skin becomes slender and shiny, and prone to trauma. Subcutaneous fat of the vulva diminishes in amount. Both the labia minora reduce in size and be inclined to disappear. The opening of the vagina gets smaller and loses its elasticity. Later on, pubic hair becomes meager and scarce.
The vagina becomes 'tent shaped' and undergoes contracture in length and width. But those continue sexual activities these chane may not appear. The uterus and cervix become small. The ovaries become atrophied and dried-up in appearance. Breasts get shriveled and tend to become flat, with the exception of in obese women, where they remain large and pendulous. This is because shrinkage is due to the glandular tissue only; fats in the breast and obese women have them in abundance.
Getting overweight after menopause:
Gaining weight is frequent at climacteric but not always, as is generally supposed. When occurs, it is associated to excessive eating to combat emotional stress, and also to change in metabolism. BMR falls significantly after the menopause, while the lady continues to eat the same amount and starts putting on weight.
Changes in heart and blood vessels after menopause:
Women at menopause may have symptoms like palpitation and occasional chest pain related to heart. But the most important symptom of menopause is 'hot flushes'. Flushing of the face and neck may be accompanied by profuse sweating particularly in the night when she reclines leading to night sweats. The basic reason of hot flushes is a increase in the pituitary hormone levels due to lowered circulating estrogen. The duration of a hot flush may vary from half a minute to several minutes. Too much drinking of alcohol, stress, anxiety, heat, or emotional outbursts may all set off a hot flush, but usually hot flushes take place without any precipitating factor.
The level of uneasiness experienced during hot flushes is variable. In some it may be so severe that pillows and bed linens are soaked due to sweat, others may just feel that they have had a disturbed night, and may vaguely remember feeling uncomfortably hot. Most women fall in between these extreme ranges. Insomnia is a natural result of hot flushes. Even if there is no sleep disturbance, there is a feeling of being neglected, dismay, downhearted and depressed. This fact is due to vasodilatation - dilatation of the peripheral blood vessels as a result of hormonal imbalance.
The frequency of coronary arterial disease is more after menopause. Estrogens have a shielding effect on the heart. At menopause, this protection is lost. Blood pressure also tends to rise.
Bones weaken and joint starts paining after menopause:
At menopause, pain in the joints and weakness of bones is also frequent. Bones become frail with the loss of calcium deposits. Increased intake of calcium containing foods such as milk and some green vegetables, along with regular exercise, can help to avert osteoporosis. It has been undoubtedly proved that bone density diminishes after menopause.
Women who have had an early menopause, whose ovaries are surgically removed during hysterectomy, or who suffers from anorexia are at elevated risk of acquiring osteoporosis. Most women have maximum bone density when they are in their thirties, after which bone mass starts declining. Minor traumas result in fractures. Hip, spine and wrist are the most susceptible. At least 1000 mg of calcium supplement along with Vitamin D is recommended daily.
Digestion problem and menopause:
Dyspepsia, indigestion, constipation and abdominal distension of varying degree may also occur during and after menopause.
Psychological Changes following menopause:
Being a major change from all aspects, menopause is viewed with uneasiness by most women. The fright of losing one's womanliness, appearing unpleasant to one's partner or acquiring cancer are very real at this stage. At menopause, women comprehend that their reproductive capacity is lost. Some wrongly regards this is an end of sexual activity and the herald of old age.
For these facts, variety if neurotic and psychotic changes occurs. Depression, irritability, mood swings, irrational behavior, nervousness, tingling or burning in the hands and feet are all common symptoms. Though some of these symptoms are related to the withdrawal of estrogen too as they sometimes disappear after giving HRT or, hormone replacement therapy. Melancholia, leading to suicidal attempts, though rare but may occur in women who have a background of mental instability.
Menopause is just the reverse of menarche. It can be turbulent and annoying for some women. Others seem to sail through menopause smoothly and gracefully. Mood swings usually last for a year or two, and then taper away gradually.
Depression is seen quite commonly in postmenopausal women, and the reasons are multifarious. A sudden drop in estrogens is probably the major cause of depression. It may also be aided by disturbed sleep, gaining weight, or feeling of chronic fatigue. This phase of life is associated with changes in the family dynamics also. Children grow up and leave home and there may be deaths in the family or extra burdens in the form of ageing parents who need care. All these can cause energy loss and thereby depression.
It is essential for the spouse to understand that menopause itself is not a disease, and the menopausal woman is not a neurotic annoyance. An thoughtful spouse can make this complex phase of changeover very simple and smooth.
This article is also published in India Study Channel
Thursday, February 26, 2009
Frigidity - causes and treatment
In my gynaecological practice frigidity is not a infrequent complain I encounter even with very young and otherwise healthy couples. Frigidity means absence of sexual desire. It is nearly due to psychological, constitutional or environmental factors. Organic disease is almost never a reason of frigidity. Some may say that dyspareunia (Pain during intercourse) leads to frigidity, but this is very rare to happen.
At times when patients of dyspareunia with perfectly normal sexual appetites, is advised to abstain from sex for a week to give time any lesion to heal often of no use!
Frigidity due to physiological reason
Some women are frigid during menstruation, pregnancy or after childbirth. This is physiological. Others develop a tremendous appetite for sex during these periods. They feel free of the fear of unwanted pregnancy; the male may be fascinated by his partner's change in status. This is also regarded as physiological Then, there are some young mothers who are simply too tired or stressed with the demands of the newborn baby to even think about courtship. As the baby grows, the mother s general well-being improves and libido returns.
Some wrong impressions in early life
Some women breed up with the thought that men are terrible creatures, and that sex is merely a wifely duty, nothing else. Discontented children in unhappy families, or those who have had a painful or terrifying sexual experience, often develop frigidity as they grow older.
Fear
Fear of pregnancy, sexually transmitted disease, or panic of being harmed by intercourse may lead to frigidity. A child's mind is open and malleable, and if sex-related horror stories are told to her again and again, she may develop frigidity later on.
Physical Fatigue and Stress may cause frigidity:
Poor health or fatigue may cause frigidity. A mind that is preoccupied with worries about work, children or housekeeping cannot be interested about sex. Women who work late till night and reach home exhausted, or those who have the dual task of balancing a demanding job with running a home, or those whose jobs leave them with unpredictable sleeping hours are the ones who are most affected. Physical fatigue is a known cause of loss of sexual desire. This factor may be opposite for men and may lead to marital conflict and more loss of libido.
Endocrine Disease
Adrenal or thyroid dysfunction and some other hormonal factors can lead to frigidity. Before counseling, any women suffering from loss of libido should consult an endocrinologist.
Contraception
Though written in many text books, my personal experience in practice it actually increases the libido by eliminating the fear of pregnancy. Some oral pill, however may cause vaginal dryness, but changing the composition of the pill usually solve the problem.
Treatment of frigidity:
In treating frigidity, explanation of the reason and explanation of it to both the partners is vital. Psychological causes require long-term treatment. There is no aphrodisiacs for women; like Viagra in men. Alcohol, in small doses, might have a advantageous effect. Perhaps it acts by temporarily removing one's inhibitions. Patient and loving partner who should understand the need and fear of the woman is most important to get rid of loss of libido.
In practice this condition is very common to encounter. While enquiring carefully taking the couple in confidence, most of the time some underlying reason is found. The cause can range from depression to drug abuse. Sex can be unappealing if there are frequent quarrels between the partners. The treatment consists of opening up the emotional blocks.
Sometimes there may be depression due to a chronic sickness, a surgery such as a mastectomy, or due to the loss of a dear one. Sometimes there may be monotony or discontented with the partner. Proper counseling with both the partners helps to solve the problem often.
Psychosexual problems:
The mind and the body have a multifaceted association with each other. Illness of the mind affects body functions, and vice versa. One cannot, therefore, regard sex as a separate matter. Sexual arousal depends not only on cyclical hormonal changes or expert techniques, but also on one's emotional status. A woman who is well attuned, has a good self image and enjoys a intimate bond with her spouse is likely to enjoy sex. It is essential for most women to sense loved and wanted before they can even start to enjoy sex.
Hormonal influences and cyclical changes also can change a woman's emotions radically and bring about diverse types of changes in different women. In the premenstrual phase, some women are keen to have sex because they feel more exited. But others, especially those who has some degree of mastalgia or breast tenderness might find sex repulsive, and they may actually find sexual foreplay painful. So there is a normal difference in an individual's sex need from day to day.
Problems crop up when the partner is not prepared for these phases in a woman's life and is unable to respond with sympathy and understanding.
It must be understood most couples living together had phases of intense sexual activity, interspersed with periods of relative inactivity. A man and a woman living together represent one unit, and at a certain point of time the energy and attention of this unit may be focused somewhere else such as acquiring of a house or on their careers.
Some women become anxious when they all of a sudden recognize that they do not seem to be having sex as regularly as before. When this happens, one has to look for some unsettled clash that could be straining the bond, or for any physical disease that is undiagnosed. Stress is one of the most common causes of sexual dysfunction. Variation in the frequency of sexual activity is no cause for worry. With physical health and emotional stability, most problems are resolved.
If necessary don’t hesitate to consult a psychiatrist for loss of sex drive.
This article is also published in India Study Channel
At times when patients of dyspareunia with perfectly normal sexual appetites, is advised to abstain from sex for a week to give time any lesion to heal often of no use!
Frigidity due to physiological reason
Some women are frigid during menstruation, pregnancy or after childbirth. This is physiological. Others develop a tremendous appetite for sex during these periods. They feel free of the fear of unwanted pregnancy; the male may be fascinated by his partner's change in status. This is also regarded as physiological Then, there are some young mothers who are simply too tired or stressed with the demands of the newborn baby to even think about courtship. As the baby grows, the mother s general well-being improves and libido returns.
Some wrong impressions in early life
Some women breed up with the thought that men are terrible creatures, and that sex is merely a wifely duty, nothing else. Discontented children in unhappy families, or those who have had a painful or terrifying sexual experience, often develop frigidity as they grow older.
Fear
Fear of pregnancy, sexually transmitted disease, or panic of being harmed by intercourse may lead to frigidity. A child's mind is open and malleable, and if sex-related horror stories are told to her again and again, she may develop frigidity later on.
Physical Fatigue and Stress may cause frigidity:
Poor health or fatigue may cause frigidity. A mind that is preoccupied with worries about work, children or housekeeping cannot be interested about sex. Women who work late till night and reach home exhausted, or those who have the dual task of balancing a demanding job with running a home, or those whose jobs leave them with unpredictable sleeping hours are the ones who are most affected. Physical fatigue is a known cause of loss of sexual desire. This factor may be opposite for men and may lead to marital conflict and more loss of libido.
Endocrine Disease
Adrenal or thyroid dysfunction and some other hormonal factors can lead to frigidity. Before counseling, any women suffering from loss of libido should consult an endocrinologist.
Contraception
Though written in many text books, my personal experience in practice it actually increases the libido by eliminating the fear of pregnancy. Some oral pill, however may cause vaginal dryness, but changing the composition of the pill usually solve the problem.
Treatment of frigidity:
In treating frigidity, explanation of the reason and explanation of it to both the partners is vital. Psychological causes require long-term treatment. There is no aphrodisiacs for women; like Viagra in men. Alcohol, in small doses, might have a advantageous effect. Perhaps it acts by temporarily removing one's inhibitions. Patient and loving partner who should understand the need and fear of the woman is most important to get rid of loss of libido.
In practice this condition is very common to encounter. While enquiring carefully taking the couple in confidence, most of the time some underlying reason is found. The cause can range from depression to drug abuse. Sex can be unappealing if there are frequent quarrels between the partners. The treatment consists of opening up the emotional blocks.
Sometimes there may be depression due to a chronic sickness, a surgery such as a mastectomy, or due to the loss of a dear one. Sometimes there may be monotony or discontented with the partner. Proper counseling with both the partners helps to solve the problem often.
Psychosexual problems:
The mind and the body have a multifaceted association with each other. Illness of the mind affects body functions, and vice versa. One cannot, therefore, regard sex as a separate matter. Sexual arousal depends not only on cyclical hormonal changes or expert techniques, but also on one's emotional status. A woman who is well attuned, has a good self image and enjoys a intimate bond with her spouse is likely to enjoy sex. It is essential for most women to sense loved and wanted before they can even start to enjoy sex.
Hormonal influences and cyclical changes also can change a woman's emotions radically and bring about diverse types of changes in different women. In the premenstrual phase, some women are keen to have sex because they feel more exited. But others, especially those who has some degree of mastalgia or breast tenderness might find sex repulsive, and they may actually find sexual foreplay painful. So there is a normal difference in an individual's sex need from day to day.
Problems crop up when the partner is not prepared for these phases in a woman's life and is unable to respond with sympathy and understanding.
It must be understood most couples living together had phases of intense sexual activity, interspersed with periods of relative inactivity. A man and a woman living together represent one unit, and at a certain point of time the energy and attention of this unit may be focused somewhere else such as acquiring of a house or on their careers.
Some women become anxious when they all of a sudden recognize that they do not seem to be having sex as regularly as before. When this happens, one has to look for some unsettled clash that could be straining the bond, or for any physical disease that is undiagnosed. Stress is one of the most common causes of sexual dysfunction. Variation in the frequency of sexual activity is no cause for worry. With physical health and emotional stability, most problems are resolved.
If necessary don’t hesitate to consult a psychiatrist for loss of sex drive.
This article is also published in India Study Channel
Tuesday, February 24, 2009
Gastro-Oesophageal Reflux Disease (GERD)- diagnosis and treatment
Gastro oesophageal reflux (GERD) is not very uncommon entity and many times this condition is termed as hyper acidity or, heartburn and may be confused with gastric ulcers and other conditions.
Contents of the stomach are highly acidic due to the secretion of hydrochloric acid. If they happen to regurgitate into the oesophagus, they irritate the lining of the latter and cause oesophagitis and ulceration. Normally the junction between the oesophagus and stomach remains closed due to the action of a sphincter, a ring of muscle tissue, which opens only to allow the food and drink to pass from the oesophagus into the stomach. In some persons or, physiologically during pregnancy
this sphincter may be weak and a backflow of fluids occur in the oesophagus and causes the symptoms.
There are various factors which increases this reflux or, back flow in susceptible persons:
Over-eating and make the stomach full up to brim. Bending forward after taking a full meal. Going to bed just after food. Wearing tight belts, smoking, old age, some drugs like Calcium antagonists (used for angina and high blood pressure) such as Diltiazem, Amlodiphine.
What are the symptoms of gastro oesophageal reflux
Heartburn is the constant symptom. Acid retching, dyspepsia is also quiet common. Oesophageal ulcer may bleed; vomiting of blood may occur. Difficulty of deglutition may appear after the formation of ulcers in the oesophagus. Cancer can form on the injured mucous membrane.
Endoscopy and barium swallow X-rays may be helpful in diagnosis.
Treatment of gastro oesophageal reflux disease (GERD):
Mild and uncomplicated cases and the event seen during pregnancy is relieved by the conservative measures like weight reduction, sleeping with the upper part of the body raised at an angle of about 30°-40°, light early dinner; avoid high fibre diet at night, i.e. eat rice in place of wheat. Do not use tight belt for your pants; suspenders are more suitable. Avoid bending forward particularly after meals. Avoid smoking, alcohol and excessive chocolate and coffee. Avoid calcium antagonist (Amlodipine) at night. Antacids, acid reducing drugs like Ranitidine or Famotidine, omeprazole, pantoprazole etc. are also helpful. Drugs which improves and regularize motility of the GI tract are also prescribed.
In intractable cases or, when there is complication surgical correction may be necessary. The procedure is known as fundoplication. Here the portion of the stomach near to the oesophageal sphincter is plicated to produce a pressure on the sphincter and thereby reducing the backflow.
80% of the patients with GERD also suffer from “Hiatus Hernia” an unusual gap in the diaphragm, which separates thoracic cavity with the abdomen. This rent is also repaired along with fundoplication. This operation is best done by laparoscopy by experts. Otherwise it is also done by opening the abdominal cavity or, the thorax depending on the situation.
This article is also published in India Study Channel
Contents of the stomach are highly acidic due to the secretion of hydrochloric acid. If they happen to regurgitate into the oesophagus, they irritate the lining of the latter and cause oesophagitis and ulceration. Normally the junction between the oesophagus and stomach remains closed due to the action of a sphincter, a ring of muscle tissue, which opens only to allow the food and drink to pass from the oesophagus into the stomach. In some persons or, physiologically during pregnancy
this sphincter may be weak and a backflow of fluids occur in the oesophagus and causes the symptoms.
There are various factors which increases this reflux or, back flow in susceptible persons:
Over-eating and make the stomach full up to brim. Bending forward after taking a full meal. Going to bed just after food. Wearing tight belts, smoking, old age, some drugs like Calcium antagonists (used for angina and high blood pressure) such as Diltiazem, Amlodiphine.
What are the symptoms of gastro oesophageal reflux
Heartburn is the constant symptom. Acid retching, dyspepsia is also quiet common. Oesophageal ulcer may bleed; vomiting of blood may occur. Difficulty of deglutition may appear after the formation of ulcers in the oesophagus. Cancer can form on the injured mucous membrane.
Endoscopy and barium swallow X-rays may be helpful in diagnosis.
Treatment of gastro oesophageal reflux disease (GERD):
Mild and uncomplicated cases and the event seen during pregnancy is relieved by the conservative measures like weight reduction, sleeping with the upper part of the body raised at an angle of about 30°-40°, light early dinner; avoid high fibre diet at night, i.e. eat rice in place of wheat. Do not use tight belt for your pants; suspenders are more suitable. Avoid bending forward particularly after meals. Avoid smoking, alcohol and excessive chocolate and coffee. Avoid calcium antagonist (Amlodipine) at night. Antacids, acid reducing drugs like Ranitidine or Famotidine, omeprazole, pantoprazole etc. are also helpful. Drugs which improves and regularize motility of the GI tract are also prescribed.
In intractable cases or, when there is complication surgical correction may be necessary. The procedure is known as fundoplication. Here the portion of the stomach near to the oesophageal sphincter is plicated to produce a pressure on the sphincter and thereby reducing the backflow.
80% of the patients with GERD also suffer from “Hiatus Hernia” an unusual gap in the diaphragm, which separates thoracic cavity with the abdomen. This rent is also repaired along with fundoplication. This operation is best done by laparoscopy by experts. Otherwise it is also done by opening the abdominal cavity or, the thorax depending on the situation.
This article is also published in India Study Channel
Female pathologies related to infertility which can be diagnosed by ultrasonography?
Uterus is the place for embryo implantation and pregnancy continuation. The normal adult uterus is a muscular organ 6-10 cm in length and 3-5 cm in width and has a unique capacity to grow and expand to hold a full term fetus during pregnancy.
TVS (Trans vaginal sonography) can accurately assess the uterine factors. Addition of fluid (saline) by sono-hysterography the cavity can be accurately studied. By color flow imaging, color doppler studies of uterine artery, power angiography, the spiral artery and endometrial vasculature can be evaluated to score the uterus for favorability of implantation.
Conditions related to infertility, which are diagnosed by USG are
Leiomayomas or fibroids:
Leiomyomas or fibroids are one of the most common benign neoplasm in women and have been reported to occur in up to 40 percent of women over the age of 35. May be an important factor for infertility can easily be diagnosed by USG. Transvaginal ultrasound is the most useful tool for screening for fibroids. The uterus is enlarged with contour deformity (Fibroid causing contour problem) and focal masses with different echogenecities (Hypoechoic usually, hyperechoic when calcified and may be isoechoic also).
A submucosal myoma within the uterine cavity, which prevent implantation of the fertilized ovum into the uterine cavity, can be picked up by the USG study.
Endometriosis
These cysts are homogenous with a low level echo patterns with good through transmission. They have fine stippling pattern filling the whole of the cyst.
Congenital Anomalies
Congenital anomalies of the uterus occur in about 0.1-0.4% of general population of women and are due to the embryological problems in Mullerian system. Congenital anomalies are a significant cause of recurrent pregnancy loss. About 80% of women with congenitally abnormal uterus may have no problem in conceiving but anomalies are responsible for almost 20% of recurrent pregnancy loss and hence should be carefully looked for and treated whenever encoun¬tered during infertility evaluation.
Uterine congenital anomalies can be diagnosed by HSG, TVS, contrast sonohysterography, hysteroscopy and laparoscopy and by a MRI 3D HSG and TVS without saline contrast are the commonest methods. The anomalies which can be diagnosed are bicornuate uterus, unicornuate uterus, intrauterine septa (complete, incomplete or arcuate).
Endometriosis of the Uterus (Adenomyosis)
Endometriosis is a disease in which typically the endometriotic implants are scattered in various extra uterine locations. However sometimes the ectopic endometrium goes into the myometrium and causes adenomyosis. These endometrial tissue starts to proliferate inside the myometrium and tends to bleed on progesterone withdra wl during the menstrual cycle thus giving the uterus a typically speckled appearance resembling 'Salt and Pepper' (Hyperecohic areas and hypoechoic areas) appearence. Depending on the extent of lesion and the severity of disease the uterus will appear enlarged and sometimes all of the adenomyosis areas may together look like a fibroid (Adenomyoma).
This article is also published in India Study Channel
TVS (Trans vaginal sonography) can accurately assess the uterine factors. Addition of fluid (saline) by sono-hysterography the cavity can be accurately studied. By color flow imaging, color doppler studies of uterine artery, power angiography, the spiral artery and endometrial vasculature can be evaluated to score the uterus for favorability of implantation.
Conditions related to infertility, which are diagnosed by USG are
Leiomayomas or fibroids:
Leiomyomas or fibroids are one of the most common benign neoplasm in women and have been reported to occur in up to 40 percent of women over the age of 35. May be an important factor for infertility can easily be diagnosed by USG. Transvaginal ultrasound is the most useful tool for screening for fibroids. The uterus is enlarged with contour deformity (Fibroid causing contour problem) and focal masses with different echogenecities (Hypoechoic usually, hyperechoic when calcified and may be isoechoic also).
A submucosal myoma within the uterine cavity, which prevent implantation of the fertilized ovum into the uterine cavity, can be picked up by the USG study.
Endometriosis
These cysts are homogenous with a low level echo patterns with good through transmission. They have fine stippling pattern filling the whole of the cyst.
Congenital Anomalies
Congenital anomalies of the uterus occur in about 0.1-0.4% of general population of women and are due to the embryological problems in Mullerian system. Congenital anomalies are a significant cause of recurrent pregnancy loss. About 80% of women with congenitally abnormal uterus may have no problem in conceiving but anomalies are responsible for almost 20% of recurrent pregnancy loss and hence should be carefully looked for and treated whenever encoun¬tered during infertility evaluation.
Uterine congenital anomalies can be diagnosed by HSG, TVS, contrast sonohysterography, hysteroscopy and laparoscopy and by a MRI 3D HSG and TVS without saline contrast are the commonest methods. The anomalies which can be diagnosed are bicornuate uterus, unicornuate uterus, intrauterine septa (complete, incomplete or arcuate).
Endometriosis of the Uterus (Adenomyosis)
Endometriosis is a disease in which typically the endometriotic implants are scattered in various extra uterine locations. However sometimes the ectopic endometrium goes into the myometrium and causes adenomyosis. These endometrial tissue starts to proliferate inside the myometrium and tends to bleed on progesterone withdra wl during the menstrual cycle thus giving the uterus a typically speckled appearance resembling 'Salt and Pepper' (Hyperecohic areas and hypoechoic areas) appearence. Depending on the extent of lesion and the severity of disease the uterus will appear enlarged and sometimes all of the adenomyosis areas may together look like a fibroid (Adenomyoma).
This article is also published in India Study Channel
How polycystic ovarian diseases (PCOD) are diagnosed in ultrasonography?
In PCOD the ovaries are increased in size. The mean volume of the ovary is 12.5 cubic cm with a range from 6 to 30 cubic cm.
The classical anatomic criteria may not be present in all patients with clinical or endocrine findings suggestive of PCOD. Therefore, an ultrasound showing ovarian enlargement can help in making the diagnosis. But It does not mean that a normal ultrasound study with normal size ovaries rule out PCOD if the clinical or biochemical abnormalities characteristic of the syndrome are present.
Ultrasound may also suggest the diagnosis of PCOD in a patient with normal sized ovaries and the clinical and or endocrine criteria of PCOD by confirming anovulation.
These are the typical findings of sonography in a case of PCOD.
The classical anatomic criteria may not be present in all patients with clinical or endocrine findings suggestive of PCOD. Therefore, an ultrasound showing ovarian enlargement can help in making the diagnosis. But It does not mean that a normal ultrasound study with normal size ovaries rule out PCOD if the clinical or biochemical abnormalities characteristic of the syndrome are present.
Ultrasound may also suggest the diagnosis of PCOD in a patient with normal sized ovaries and the clinical and or endocrine criteria of PCOD by confirming anovulation.
These are the typical findings of sonography in a case of PCOD.
- Enlarged ovary (more than 8 cubic cm)
- Multiple small cysts (0.2-0.6 cm)
- Anovulation (lack of follicular development)
- Resting or follicular endometrium
Monday, February 23, 2009
Role of ultrasonography in male infertility
Ultrasound Assessment of the Mate Partner
Male factor infertility today comprises almost 40% of the causes in an infertile male. The modern life style and additives in food have became a major environ¬mental cause of oligoasthenospermia.
The function of male genital system encompasses the central nervous system (hypothalamus and pituitary), the adrenal glands, the testes, the epididymis, the seminal vesicles and the prostate gland. Any malfunctions of any of these may affect the male reproductive capacity.
Scrotal and transrectal (TRUS) are used in evaluation of the reproductive tract disorders. Color flow imaging is used for assessment of varicocele. 3-D is used for testicular volume and seminal vesicle and prostate evaluation. Computed tomography and endorectal Magnetic Resonance Imaging can also be used.
Scrotal sonography
Scrotal sonography is performed with patient in supine position using a special small probe. This can evaluate the testis for size, shape, hydrocele, benign tumours, atrophy, malignancy, orchitis, torsion, haemorrhage, focal lesions, etc. Ultrasound imaging is very sensitive in testicular evaluation.
Transrectal Ultrasonography (TRUS)
Transrectal Ultrasonography (TRUS) is an excellent approach for visualising the seminal vesicles, prostate and ejaculatory ducts. With TRUS we can assess obstructions, absence or hypoplasia of seminal vesicle and ejaculatory ducts. TRUS is an excellent screening test for ejaculatory duct pathologies and is indicated in all men with severe oligospermia and a low volume ejaculate.
This article is also published in India Study Channel
Male factor infertility today comprises almost 40% of the causes in an infertile male. The modern life style and additives in food have became a major environ¬mental cause of oligoasthenospermia.
The function of male genital system encompasses the central nervous system (hypothalamus and pituitary), the adrenal glands, the testes, the epididymis, the seminal vesicles and the prostate gland. Any malfunctions of any of these may affect the male reproductive capacity.
Scrotal and transrectal (TRUS) are used in evaluation of the reproductive tract disorders. Color flow imaging is used for assessment of varicocele. 3-D is used for testicular volume and seminal vesicle and prostate evaluation. Computed tomography and endorectal Magnetic Resonance Imaging can also be used.
Scrotal sonography
Scrotal sonography is performed with patient in supine position using a special small probe. This can evaluate the testis for size, shape, hydrocele, benign tumours, atrophy, malignancy, orchitis, torsion, haemorrhage, focal lesions, etc. Ultrasound imaging is very sensitive in testicular evaluation.
Transrectal Ultrasonography (TRUS)
Transrectal Ultrasonography (TRUS) is an excellent approach for visualising the seminal vesicles, prostate and ejaculatory ducts. With TRUS we can assess obstructions, absence or hypoplasia of seminal vesicle and ejaculatory ducts. TRUS is an excellent screening test for ejaculatory duct pathologies and is indicated in all men with severe oligospermia and a low volume ejaculate.
This article is also published in India Study Channel
Predict ovulation in infertile couples by Ultrasonography
What the sonologist sees to predict ovulation?
A small echogenic mass that is thought to represent the cumulus oophorus may sometimes be noted projecting into the follicle. Visualization of the cumulus oophorus has been reported in 80 percent of follicles greater than 17 mm in diameter. Ovulation is reported to be within 36 hours of seeing the cumulus. After the LH surge, the theca tissue becomes hypervascular and edematous and the granulosa cell layer begins to separate from the theca layer. This is appreciated sonographically as a line of decreased reflectivity around the follicle. Within 6 to 10 hours before ovulation, separation and folding of the granu¬losa cell layer produces a crenation or irregularity of the lining of the follicle. This has also been suggested as sign of impending ovulation. Unfortunately, despite the fact that there are a number of sonographic signs that have been described to precede ovulation, there is currently no sonography sign that predicts exactly when ovulation will occur, the signs only give evidence that the time of ovulation is nearing. The mean peak diameter before ovulation reported by Kerin et al was 23.6 + 0.4 mm. However, there are considerable differences in the same.
Hence, the potential signs of impending ovulation are:
• Presence of a dominant follicle (usually more than 16 to 18 mm)
• Anechoic area, double contour, around the follicle (possible ovulation within 24 hrs)
• Separation and folding of the follicle lining (ovulation within 6 to 10 hrs)
• Thickened proliferative endometrium (described later)
How USG confirms that there is ovulation?
Sonography does appear to be very reliable in confirming ovulation once ovulation has occurred. Disappearance of the follicle is noted in 91 percent of cases after ovulation and a decrease in follicle size occurs in another 9 percent. Other signs suggesting that ovulation has occurred are the appearance of cul-de-sac fluid, particularly when it was not present in a previous scan, or the development of intratollicular echoes suggesting the formation of a hemorrhagic corpus luteum.
How anovulation is diagnosed by sonography?
In an anovulatory cycle, ultrasound imaging of the ovaries will reveal either a lack of any follicular development, particularly in the hypogonadotropic hypogonadal patient WHO type I or a few non ovulatory (less than 11 mm) follicles. A dominant follicle larger than 16 mm in diameter will not develop. A cyst may also be associated with anovulation. Anovulation with PCOD will often have enlarged ovaries greater than 8 cm3 in volume with multiple small subcapsular follicles less than 10 mm in diameter. However, normal sized ovaries do not rule out PCOD. Anovulation can be diagnosed when serial scans do not show development of a follicle. A mature corpus luteum is noted sonographically in about 50 percent of patients after ovulation. If pregnancy does not occur the corpus luteum generally degenerates and disappears just before menstruation. Corpus luteum cysts may be 4 to 6 cms in diamter and occasionally even large but are more commonly 2.5 to 3 cms in diameter. They may persist for 4 to 12 weeks and may be responsible for suppressing normal follicular development until they resolve.
This article is also published in India Study Channel
A small echogenic mass that is thought to represent the cumulus oophorus may sometimes be noted projecting into the follicle. Visualization of the cumulus oophorus has been reported in 80 percent of follicles greater than 17 mm in diameter. Ovulation is reported to be within 36 hours of seeing the cumulus. After the LH surge, the theca tissue becomes hypervascular and edematous and the granulosa cell layer begins to separate from the theca layer. This is appreciated sonographically as a line of decreased reflectivity around the follicle. Within 6 to 10 hours before ovulation, separation and folding of the granu¬losa cell layer produces a crenation or irregularity of the lining of the follicle. This has also been suggested as sign of impending ovulation. Unfortunately, despite the fact that there are a number of sonographic signs that have been described to precede ovulation, there is currently no sonography sign that predicts exactly when ovulation will occur, the signs only give evidence that the time of ovulation is nearing. The mean peak diameter before ovulation reported by Kerin et al was 23.6 + 0.4 mm. However, there are considerable differences in the same.
Hence, the potential signs of impending ovulation are:
• Presence of a dominant follicle (usually more than 16 to 18 mm)
• Anechoic area, double contour, around the follicle (possible ovulation within 24 hrs)
• Separation and folding of the follicle lining (ovulation within 6 to 10 hrs)
• Thickened proliferative endometrium (described later)
How USG confirms that there is ovulation?
Sonography does appear to be very reliable in confirming ovulation once ovulation has occurred. Disappearance of the follicle is noted in 91 percent of cases after ovulation and a decrease in follicle size occurs in another 9 percent. Other signs suggesting that ovulation has occurred are the appearance of cul-de-sac fluid, particularly when it was not present in a previous scan, or the development of intratollicular echoes suggesting the formation of a hemorrhagic corpus luteum.
How anovulation is diagnosed by sonography?
In an anovulatory cycle, ultrasound imaging of the ovaries will reveal either a lack of any follicular development, particularly in the hypogonadotropic hypogonadal patient WHO type I or a few non ovulatory (less than 11 mm) follicles. A dominant follicle larger than 16 mm in diameter will not develop. A cyst may also be associated with anovulation. Anovulation with PCOD will often have enlarged ovaries greater than 8 cm3 in volume with multiple small subcapsular follicles less than 10 mm in diameter. However, normal sized ovaries do not rule out PCOD. Anovulation can be diagnosed when serial scans do not show development of a follicle. A mature corpus luteum is noted sonographically in about 50 percent of patients after ovulation. If pregnancy does not occur the corpus luteum generally degenerates and disappears just before menstruation. Corpus luteum cysts may be 4 to 6 cms in diamter and occasionally even large but are more commonly 2.5 to 3 cms in diameter. They may persist for 4 to 12 weeks and may be responsible for suppressing normal follicular development until they resolve.
This article is also published in India Study Channel
Tea, Coffee and colas - How good are they for our health
Cold drinks and hot beverages has become an integrated element of today’s modern society. We cannot avoid these drinks when we mix socially. These drinks are not at all bad if taken in moderation but excessive use may harm our health. In this article let us know about these drinks; and how our health is related with their consumption.
Common drinks and their ingredients; we take daily at our home and social gathering:
Tea, coffee, cocoa (chocolate) and colas contain xanthines mainly in the form of caffeine and theophylline as active ingredients which are responsible for their stimulating and diuretic effects.
Tea has been shown to contain anti-oxidant flavonoids in addition which protect the body against heart disease and cancer.
Fruit juices contain vitamins and anti-oxidants which delay the ageing process. They do not contain stimulants.
Effect of Caffeine and other xanthines in tea or, coffee on our body:
*They stimulate mental activity, making the thought process more rapid.
*Remove fatigue.
*Improve physical and mental performance by reducing fatigue or boredom.
*Makes the person more alert, shortens sleep.
*Directly stimulates the heart.
*Temporarily elevates blood pressure; effect lasting many hours.
*Combination of stress and caffeine cause additive rise in BP.
*Act as diuretic.
*Theophylline opens up constricted airways of asthma and asthmatic bronchitis and eases breathing.
*A degree of emotional dependence gradually develops.
Undesirable effects of excessive caffeine
#Anxiety, tension and tremors; deteriorating mental performance. Preventing sleep it reduces the level of physical and mental performance.
Diuretic effect disturbs sleep further.
#Overstimulation of the heart causes palpitations and premature beats (extra-systoles).
#Ulcer of the stomach may get worse.
For your ready reference here are the list of amount of caffeine in your favorite drinks
One cup of coffee = 80 mg of caffeine
One cup of tea = 30 mg of caffeine
One cup Chocolate drinks and cocoa = 30 mg caffeine
300ml of cola drink = 40mg of caffeine
Effect of caffeine You can easily calculate your allowances of caffeine according to your age.
Effect of caffeine in children
Child’s delicate stomach cannot tolerate irritant effect of coffee, and they are less tolerant of the stimulant effect and emotional dependence develops early.
Comparison of effects of caffeine (Tea, coffee and colas) between young and elderly
All effects of tea, coffee and cola drinks are more pronounced among the elderly than among younger people, particularly loss of sleep and increased urination. This aggravates the problems caused by enlarged prostate which is common among elderly men.
Other precautions to be taken for taking caffeine
As there is delayed effect of coffee in elderly, it may cause problem in sleep at night, though it is taken earlier. Lighter coffee like coffee chicory mixture is better for them.
Individuals at high risk for hypertension should abstain from routine use of caffeinated drinks particularly when stress at work place is high.
Avoid excessive amount of sugar, to prevent obesity.
Avoid decaffeinated coffee, because it has been linked to cancer; in its manufacture, chemicals are used, traces of which are left behind in the finished product and act as carcinogens.
This article is also published in India Study Channel
Common drinks and their ingredients; we take daily at our home and social gathering:
Tea, coffee, cocoa (chocolate) and colas contain xanthines mainly in the form of caffeine and theophylline as active ingredients which are responsible for their stimulating and diuretic effects.
Tea has been shown to contain anti-oxidant flavonoids in addition which protect the body against heart disease and cancer.
Fruit juices contain vitamins and anti-oxidants which delay the ageing process. They do not contain stimulants.
Effect of Caffeine and other xanthines in tea or, coffee on our body:
*They stimulate mental activity, making the thought process more rapid.
*Remove fatigue.
*Improve physical and mental performance by reducing fatigue or boredom.
*Makes the person more alert, shortens sleep.
*Directly stimulates the heart.
*Temporarily elevates blood pressure; effect lasting many hours.
*Combination of stress and caffeine cause additive rise in BP.
*Act as diuretic.
*Theophylline opens up constricted airways of asthma and asthmatic bronchitis and eases breathing.
*A degree of emotional dependence gradually develops.
Undesirable effects of excessive caffeine
#Anxiety, tension and tremors; deteriorating mental performance. Preventing sleep it reduces the level of physical and mental performance.
Diuretic effect disturbs sleep further.
#Overstimulation of the heart causes palpitations and premature beats (extra-systoles).
#Ulcer of the stomach may get worse.
For your ready reference here are the list of amount of caffeine in your favorite drinks
One cup of coffee = 80 mg of caffeine
One cup of tea = 30 mg of caffeine
One cup Chocolate drinks and cocoa = 30 mg caffeine
300ml of cola drink = 40mg of caffeine
Effect of caffeine You can easily calculate your allowances of caffeine according to your age.
Effect of caffeine in children
Child’s delicate stomach cannot tolerate irritant effect of coffee, and they are less tolerant of the stimulant effect and emotional dependence develops early.
Comparison of effects of caffeine (Tea, coffee and colas) between young and elderly
All effects of tea, coffee and cola drinks are more pronounced among the elderly than among younger people, particularly loss of sleep and increased urination. This aggravates the problems caused by enlarged prostate which is common among elderly men.
Other precautions to be taken for taking caffeine
As there is delayed effect of coffee in elderly, it may cause problem in sleep at night, though it is taken earlier. Lighter coffee like coffee chicory mixture is better for them.
Individuals at high risk for hypertension should abstain from routine use of caffeinated drinks particularly when stress at work place is high.
Avoid excessive amount of sugar, to prevent obesity.
Avoid decaffeinated coffee, because it has been linked to cancer; in its manufacture, chemicals are used, traces of which are left behind in the finished product and act as carcinogens.
This article is also published in India Study Channel
Insomnia or sleeping trouble - not a rare problem today!
Sound uninterrupted sleep is vital for optimal health. Not everyone gets sound sleep regularly.
Why is sleep disturbed?
Why are some people habitually light sleepers?
How can the condition be corrected?
In this article answers of these important questions will be found.
Sleep is a natural event required for rest and recovery of body and mind after the activity of the whole day. We have inbuilt biological clocks in our system, one of which regulates sleep. That is why we feel sleepy around the same time every day.
What are the basic pre requisites for sound sleep?
*Our body should be free from any sort of pain, mildly tired but not exhausted.
*Mind should be calm free of anxiety.
*Comfortable and reasonable size bed.
*Comfortable bedroom temperature and humidity.
*Pleasant color of the walls and furniture of the bed room.
*Lighting of one’s choice. This vary from person to person.Some people cannot sleep in total dark; a small night lamp in a corner of the room below the height of the beds and invisible to the eyes, or in the adjoining bathroom is an advantage.
*Night clothing should be loose.
*Understanding between spouses is an important factor.
*Calm atmosphere, without disturbing noise.
Factors may disturb sleep are:
Absence of above mentioned basic pre requisites and..
#Caffeine due to excessive consumption of tea, coffee or cola drinks, especially in the evening or at night.
#Excessive smoking.
#Excess alcohol.
#Disruption of sleep rhythm due to late-night engagements and parties.
#Irregular hours of sleep as in shift workers.
These factors if continue for long time, there will be gross disruption of biological circadian rhythm and a person suffers from sleep disorder.
Elders are more sufferers of sleep disturbances
*The young are relatively less affected by adverse factors mentioned above because they have large reserves in the brain which make them withstand sleep abuse much better.
*Depleted body reserves in the elderly leads to greater disturbance in sleep.
*Enlargement of the prostate in elderly males and frequent trips to the bathroom at night is a frequent cause of loss or disturbance of sleep.
How to get a sound sleep?
If you recline awake in bed in the dark or semi dark at night, trying to induce sleep, you will be disappointed. Don’t lie down in bed without clear indication of sleep. Try reading some light story book or watch TV and whenever you start yawning lie down in semi awake state by putting off the TV with the remote control. Don’t start roaming about and closing the door, checking the locks etc. Do these before you start reading book or watching the TV. Yiu may not get the result immediately, but within a few days your body will adjust its own clock ans you will have no problem thereafter. Respect your biological clock. If your are an 'owl' or night person, you will not be able to sleep early nor get up early. If you are a lark' or morning person, you will want to sleep early and your biological clock will wake you up early.
Should one use sleeping pills or tranquillizers?
Occasional use of these drugs when you are very disturbed for some reason may be justified but do not take them regularly. They are habit-forming drugs and do not bring natural sleep. Most of these drugs result in a hangover the next day which may disturb your work. You may have to increase the dose every now and then to produce the same effect. In course of time some of them are themselves known to produce a state of anxiety and insomnia. If a tranquillizer has to be used more than occasionally, it should never be used for more than two or three weeks.
Bottom line:
Try to identify the cause or causes which are keeping you awake and remove them. They may be trivial such as a night dress which is too tight, a blocked nose, acidity of the stomach or simply an overfull stomach.
This article is also published in India Study Channel
Why is sleep disturbed?
Why are some people habitually light sleepers?
How can the condition be corrected?
In this article answers of these important questions will be found.
Sleep is a natural event required for rest and recovery of body and mind after the activity of the whole day. We have inbuilt biological clocks in our system, one of which regulates sleep. That is why we feel sleepy around the same time every day.
What are the basic pre requisites for sound sleep?
*Our body should be free from any sort of pain, mildly tired but not exhausted.
*Mind should be calm free of anxiety.
*Comfortable and reasonable size bed.
*Comfortable bedroom temperature and humidity.
*Pleasant color of the walls and furniture of the bed room.
*Lighting of one’s choice. This vary from person to person.Some people cannot sleep in total dark; a small night lamp in a corner of the room below the height of the beds and invisible to the eyes, or in the adjoining bathroom is an advantage.
*Night clothing should be loose.
*Understanding between spouses is an important factor.
*Calm atmosphere, without disturbing noise.
Factors may disturb sleep are:
Absence of above mentioned basic pre requisites and..
#Caffeine due to excessive consumption of tea, coffee or cola drinks, especially in the evening or at night.
#Excessive smoking.
#Excess alcohol.
#Disruption of sleep rhythm due to late-night engagements and parties.
#Irregular hours of sleep as in shift workers.
These factors if continue for long time, there will be gross disruption of biological circadian rhythm and a person suffers from sleep disorder.
Elders are more sufferers of sleep disturbances
*The young are relatively less affected by adverse factors mentioned above because they have large reserves in the brain which make them withstand sleep abuse much better.
*Depleted body reserves in the elderly leads to greater disturbance in sleep.
*Enlargement of the prostate in elderly males and frequent trips to the bathroom at night is a frequent cause of loss or disturbance of sleep.
How to get a sound sleep?
If you recline awake in bed in the dark or semi dark at night, trying to induce sleep, you will be disappointed. Don’t lie down in bed without clear indication of sleep. Try reading some light story book or watch TV and whenever you start yawning lie down in semi awake state by putting off the TV with the remote control. Don’t start roaming about and closing the door, checking the locks etc. Do these before you start reading book or watching the TV. Yiu may not get the result immediately, but within a few days your body will adjust its own clock ans you will have no problem thereafter. Respect your biological clock. If your are an 'owl' or night person, you will not be able to sleep early nor get up early. If you are a lark' or morning person, you will want to sleep early and your biological clock will wake you up early.
Should one use sleeping pills or tranquillizers?
Occasional use of these drugs when you are very disturbed for some reason may be justified but do not take them regularly. They are habit-forming drugs and do not bring natural sleep. Most of these drugs result in a hangover the next day which may disturb your work. You may have to increase the dose every now and then to produce the same effect. In course of time some of them are themselves known to produce a state of anxiety and insomnia. If a tranquillizer has to be used more than occasionally, it should never be used for more than two or three weeks.
Bottom line:
Try to identify the cause or causes which are keeping you awake and remove them. They may be trivial such as a night dress which is too tight, a blocked nose, acidity of the stomach or simply an overfull stomach.
This article is also published in India Study Channel
Degenerative joint diseases - Diagnosis and treatment
Joints start degenerating with age progressively after the age of thirty along with other organs of the body.
Degenerative joint disease is also called osteoarthritis (OA) has following components:
*Loss of joint cartilage
*New bone (osteophyte) formation in and around the affected joint.
*Disorganization of the joint.
Injury to a joint hastens the degenerative process. While some degree of osteoarthritic change is inevitable, only 25 per cent persons suffer from pain.
Common joints affected by osteoarthritis:
Commonly affected joints are the weight-bearing and frequently used joints:
*Joints of the fingers
*Knees
*Hip
*Neck (cervical spondylosis),
*Lower back (dorso-lumbar spondylosis).
What are the symptoms of osteoarthritis?
Pain is a constant symptom and usually limited to one or two joints. Pain is caused by irritation of nerves and spasm of muscles and ligaments adjoining the affected joint.
Stiffness in the morning or after rest, which usually relieved by movement or exercise.
Joint mobility may become restricted.
Crepitus (a soft crackling sound) may be felt and/or heard on moving the joints.
Pain and stiffness usually change with changes of weather.
Lumbar spondylosis causes chronic aching pain in the lower back. It sometimes aggravates to severe pain (lumbago). When this pain radiates to the thigh and legs, due to compression of nerves coming out from the spinal cord, it is known as sciatica.
Cervical spondylosis produces similar pain in the neck. Due to compression of nerves pain and spasm radiate to the shoulder and arm. This pain may mimic cardiac pain (heart attack). ECG will be required to distinguish the cardiac pain from the pain of cervical spondylosis.
What factors make one more susceptible to osteoarthritis?
#Obesity
#Sedentary life
#Lack of exercise
#Idleness make muscles weak and flabby; such muscles go into spasm and cause pain more readily than strong ones.
How to get relief from osteoarthritis?
Treatment of acute pain from osteoarthritis
*Rest for two or three days. Prolonged rest may worsen the situation.
*Local heat with hot water bottle, infra-red rays, short-wave diathermy(available in physiotherapy centers),
*External applications such as salicylate or diclofenac ointment.
*Injection of corticosteroid into the affected joint.
*NSAID such as aspirin, ibuprofen other newest NSAID in minimum effective dose for minimum number of days.
*Joint supports such as knee cap, cervical collar, to be used for minimum number of days and only during physical activity;
remove it when resting or not active.
Treatment of chronic pain of osteoarthritis
As soon as the acute pain is relieved, which may take two to three days, start the following.
*Isometric exercises to strengthen the muscles of the affected joint. This is the most important part of the treatment. You can learn the exercises required for you from an experienced physiotherapist or, orthopaedic surgeon.
Reduce weight if you are obese. More weight cause more strain to the weight bearing joints and they fail to recover.
*Maintain physically active lifestyle and exercise regularly. In manual workers and those who regularly exercise the problems connected with OA are less frequent, less troublesome and appear at a later age.
*If you have backache, use a hard bed with three inches thick rubberized-coir mattress for sleep. This provides both support and comfort. Hard bed does not mean you have to sleep on a hard surface.
*If you have cervical spondylosis, better not to use normal pillow. A rolled-up towel under the nape of the neck (not under the head) can be placed instead. Cervical collar is to be used when there is acute pain and not regularly. Cervical traction may be useful. If this is needed the treating surgeon and the physiotherapist will guide about the method and duration of such traction. Exercises to toughen muscles of the neck to start as soon as acute stage is over.
*In the case of weight bearing joints (knee or hip), implantation of an artificial joint may have to be considered if the joint is badly disorganized and patient completely incapacitated.
This article is also published in India Study Channel
Degenerative joint disease is also called osteoarthritis (OA) has following components:
*Loss of joint cartilage
*New bone (osteophyte) formation in and around the affected joint.
*Disorganization of the joint.
Injury to a joint hastens the degenerative process. While some degree of osteoarthritic change is inevitable, only 25 per cent persons suffer from pain.
Common joints affected by osteoarthritis:
Commonly affected joints are the weight-bearing and frequently used joints:
*Joints of the fingers
*Knees
*Hip
*Neck (cervical spondylosis),
*Lower back (dorso-lumbar spondylosis).
What are the symptoms of osteoarthritis?
Pain is a constant symptom and usually limited to one or two joints. Pain is caused by irritation of nerves and spasm of muscles and ligaments adjoining the affected joint.
Stiffness in the morning or after rest, which usually relieved by movement or exercise.
Joint mobility may become restricted.
Crepitus (a soft crackling sound) may be felt and/or heard on moving the joints.
Pain and stiffness usually change with changes of weather.
Lumbar spondylosis causes chronic aching pain in the lower back. It sometimes aggravates to severe pain (lumbago). When this pain radiates to the thigh and legs, due to compression of nerves coming out from the spinal cord, it is known as sciatica.
Cervical spondylosis produces similar pain in the neck. Due to compression of nerves pain and spasm radiate to the shoulder and arm. This pain may mimic cardiac pain (heart attack). ECG will be required to distinguish the cardiac pain from the pain of cervical spondylosis.
What factors make one more susceptible to osteoarthritis?
#Obesity
#Sedentary life
#Lack of exercise
#Idleness make muscles weak and flabby; such muscles go into spasm and cause pain more readily than strong ones.
How to get relief from osteoarthritis?
Treatment of acute pain from osteoarthritis
*Rest for two or three days. Prolonged rest may worsen the situation.
*Local heat with hot water bottle, infra-red rays, short-wave diathermy(available in physiotherapy centers),
*External applications such as salicylate or diclofenac ointment.
*Injection of corticosteroid into the affected joint.
*NSAID such as aspirin, ibuprofen other newest NSAID in minimum effective dose for minimum number of days.
*Joint supports such as knee cap, cervical collar, to be used for minimum number of days and only during physical activity;
remove it when resting or not active.
Treatment of chronic pain of osteoarthritis
As soon as the acute pain is relieved, which may take two to three days, start the following.
*Isometric exercises to strengthen the muscles of the affected joint. This is the most important part of the treatment. You can learn the exercises required for you from an experienced physiotherapist or, orthopaedic surgeon.
Reduce weight if you are obese. More weight cause more strain to the weight bearing joints and they fail to recover.
*Maintain physically active lifestyle and exercise regularly. In manual workers and those who regularly exercise the problems connected with OA are less frequent, less troublesome and appear at a later age.
*If you have backache, use a hard bed with three inches thick rubberized-coir mattress for sleep. This provides both support and comfort. Hard bed does not mean you have to sleep on a hard surface.
*If you have cervical spondylosis, better not to use normal pillow. A rolled-up towel under the nape of the neck (not under the head) can be placed instead. Cervical collar is to be used when there is acute pain and not regularly. Cervical traction may be useful. If this is needed the treating surgeon and the physiotherapist will guide about the method and duration of such traction. Exercises to toughen muscles of the neck to start as soon as acute stage is over.
*In the case of weight bearing joints (knee or hip), implantation of an artificial joint may have to be considered if the joint is badly disorganized and patient completely incapacitated.
This article is also published in India Study Channel
How stress can be dealt
Three ways to deal with stress are:
1. Avoid stress, if possible
2. Utilize stress to your advantage, if you can
3. Cope with stress to prevent disease
How to Avoid Stress
Commonest cause of stress at work is dissatisfaction with job and the commonest cause at home is marital disharmony. Therefore choose your career as well as mate with utmost care. Encourage, develop and strengthen areas of agreement at home.
Learn to enjoy your work by learning everything about your work and doing it to the best of your ability. Have a measure of control over your work—it is important for your happiness. Success may bring jealousies at work and are frequent cause of stress. Modesty and courtesy prevent the circumstances of hostility.
How to Utilize Stress to Your Advantage
• The road to reducing stress in our lives is 'EFFICIENCY'
• Stress provides an opportunity to improve our performance.
• Learn to accomplish more with less effort by avoiding wastage of effort.
• Seize control of success by replacing fear with confidence commitment, dedication and concentration.
• Define what is best to do and do it.
• Take calculated risks.
• Repeat past behavior that produced top performance-the more you repeat this behavior, the more will it become second nature with you.
• "A strong will, a settled purpose and invincible determination can accomplish anything" (Thomas Fuller).
• Each one of us has the potential to become a top performer
• It is top performance which gives happiness and joy and keeps the ill-effects of stress away.
How to cope with stress
• Make a conscious effort to control stress. There should be a daily routine to shed stress.
• To this end listen to music, meditate, develop hobbies, exercise, go for a leisurely stroll, or a joy ride in a bus or car.
• If you cannot go out, indulge in a hobby, e. g. play your guitar, sitar or violin
• Caffeine in any form heightens the stress level. Coffee is the worst offender; others are tea and cola drinks. Restrict their consumption.
• Sometimes circumstances may be beyond your control, a crisis in the family for example, or stress may gradually build up over months. Small irritations, loss of temper and frayed nerves may add up over a period of time. It is then that stress becomes distress and exerts its ill-effects. You should then back off, relax and prevent the situation from overwhelming you. At this point of time forget everything and go on a quiet holiday for a couple of weeks. You will come back refreshed.
Meditation:
Relaxation through meditation is becoming increasingly popular both in India and abroad. It is practiced in many ways. The principles are: Use a simple mental device which may be a 'mantra', a simple word or a visual symbol to relax the mind. Concentrate on the mental device, to the exclusion of everything else. The body will start relaxing. This happens because the mental device blots out all distracting thoughts. The technique is best learnt in a meditation centers.
This article is also published at India Study Channel
1. Avoid stress, if possible
2. Utilize stress to your advantage, if you can
3. Cope with stress to prevent disease
How to Avoid Stress
Commonest cause of stress at work is dissatisfaction with job and the commonest cause at home is marital disharmony. Therefore choose your career as well as mate with utmost care. Encourage, develop and strengthen areas of agreement at home.
Learn to enjoy your work by learning everything about your work and doing it to the best of your ability. Have a measure of control over your work—it is important for your happiness. Success may bring jealousies at work and are frequent cause of stress. Modesty and courtesy prevent the circumstances of hostility.
How to Utilize Stress to Your Advantage
• The road to reducing stress in our lives is 'EFFICIENCY'
• Stress provides an opportunity to improve our performance.
• Learn to accomplish more with less effort by avoiding wastage of effort.
• Seize control of success by replacing fear with confidence commitment, dedication and concentration.
• Define what is best to do and do it.
• Take calculated risks.
• Repeat past behavior that produced top performance-the more you repeat this behavior, the more will it become second nature with you.
• "A strong will, a settled purpose and invincible determination can accomplish anything" (Thomas Fuller).
• Each one of us has the potential to become a top performer
• It is top performance which gives happiness and joy and keeps the ill-effects of stress away.
How to cope with stress
• Make a conscious effort to control stress. There should be a daily routine to shed stress.
• To this end listen to music, meditate, develop hobbies, exercise, go for a leisurely stroll, or a joy ride in a bus or car.
• If you cannot go out, indulge in a hobby, e. g. play your guitar, sitar or violin
• Caffeine in any form heightens the stress level. Coffee is the worst offender; others are tea and cola drinks. Restrict their consumption.
• Sometimes circumstances may be beyond your control, a crisis in the family for example, or stress may gradually build up over months. Small irritations, loss of temper and frayed nerves may add up over a period of time. It is then that stress becomes distress and exerts its ill-effects. You should then back off, relax and prevent the situation from overwhelming you. At this point of time forget everything and go on a quiet holiday for a couple of weeks. You will come back refreshed.
Meditation:
Relaxation through meditation is becoming increasingly popular both in India and abroad. It is practiced in many ways. The principles are: Use a simple mental device which may be a 'mantra', a simple word or a visual symbol to relax the mind. Concentrate on the mental device, to the exclusion of everything else. The body will start relaxing. This happens because the mental device blots out all distracting thoughts. The technique is best learnt in a meditation centers.
This article is also published at India Study Channel
Friday, February 20, 2009
Physical Exercise - Common questions answered
One's capability for physical exertion and exercise is an important determinant of the health of the heart and lungs. There is no longer any uncertainty that regular exercise of reasonable intensity prolongs the lifespan by improving one's vigor, delaying aging process and preventing chronic degenerative diseases such as heart attack, stroke and cancer.
Persistently sedentary life is associated with significantly higher risk of mortality particularly from heart disease. The risk is even greater if chronic diseases like hypertension and diabetes co exist.
The level of physical fitness can be enhanced by a physically active lifestyle and regular exercise.
The reduction of risk has no relation with the basic fitness level; hence even though anyone has not been active in the past, will gain by physical activity.
How one can gain from physical exercise?
*Physical exercise burns excess calories and keeps body weight to healthy level.
*Keeps the blood sugar
at normal level.
*Improves lipid (fat) profile of blood by elevating the level of good cholesterol (HDL) and lowering the level of bad cholesterol (LDL).
*Lowers blood pressure.
Chance of thrombosis in the arteries of heart, brain, legs, etc. are reduced to a great extant.
*Improves the function of the lungs by opening up air spaces, improving oxygenation of blood and getting rid of excess secretions and phlegm.
*Heart function is also improved by increasing flow of blood in the coronary arteries which prevents build-up of cholesterol deposits, and opens up dormant collateral blood vessels which act as bypasses if arterial obstruction develops.
*Exercising also reduce likelihood of rhythm disturbances of the heart, thus reducing the risk of cardiac arrest.
*General improvement of metabolism and strengthening of immune system, which helps prevent/fight infections and even cancers.
What is the fitness level desired?
Excessive exercise produces oxidative stress and actually may harm; particularly for the elderly.
What is needed is regular exercise of moderate intensity and a physically active lifestyle, so that in course of time you are able to walk at full speed (120 steps per minute) for 20 minutes continuously and cover a distance of one mile (1.6 km) without difficulty.
For a sedentary person, it may require a few months of regular exercise to reach this stage of fitness; allow it to take its own time.
How much one should exercise?
Exercise should be strong enough to produce a bit of rapid breathing and sweating with 70-80 per cent of age-adjusted maximal heart (pulse) rate. Keep up the activity for 20-30 minutes four or five times a week. Before and after exercise there should be warm-up and cool-down periods of a few minutes each.
To arrive at your age-adjusted maximal heart rate subtract your age in years from 220. Thus a t age 50, your maximal heart rate is 220-50=170. You should therefore be exercising to produce a heart rate of 70-80 per cent of 170, i.e. 119 to 136 per minute.
What are the types of exercises we can easily do?
The exercises should be such as to involve large muscle masses like:
• walking,
• dancing,
• swimming,
• cycling, etc.
During and after middle age, walking is the best form of exercise. In old age it is almost the only exercise that one should perform.
All competitive activities should stop by the age of 35. After that, the games may be played only with the idea of fun and exercise.
Modern gadgets don’t offer added advantage except you can do it at your home at your own pace.
To be effective, exercise must be continued for progressively longer periods each week till it can be maintained for 20-30 minutes continuously.
Alternative approach is to accumulate daily activity in segments of 10 minutes each to a total of 30 minutes as described later in the article.
The slow progression is particularly important for the elderly, those unaccustomed to exercise and those with evidence of hypertension, diabetes or heart disease.
The long-term aim is to reach and maintain a minimum level of physical fitness.
Good effects on blood pressure, blood sugar, heart disease, body weight, etc., take time to appear and full effect takes almost one year. Once the effects are felt, it is important to maintain the same level of exercise and not become complacent.
How one can incorporate one’s lifestyle with physical activity?
There are numerous ways in which you can integrate physical activity in your daily life, such as:
• use stairs and not the lift to go upstairs,
• use a cycle instead of a car for distances less than 5 km.
• go to the market on foot or cycle, etc.
• perform household chores yourself such as cleaning the house, making beds, washing clothes.
Accumulated Daily Activity Programme
Practical recommendations of the expert panel of US Institute of Health may suit sedentary persons who find it difficult to allot time for regular exercise:
“All children and adults should gradually build 30 minutes of physical activity of moderate intensity (walking, climbing stairs, gardening, cycling.) on most preferably all, days of the week.”
These 30 minutes can be accumulated through segments of 10 minutes duration.
What are the precautions before starting any exercise program?
Consult your physician before staring exercising
• If you are 40 (men) or 50 (women).
• You have risk factors such as hypertension, diabetes, smoking, etc.
• If you have evidence of ischaemic heart disease or any other disease affecting major organs.
The exercise should be such that it produces a pleasant sense of tiredness which disappears after a little rest.
If you experience any adverse symptoms such as tightness or pain in the chest, undue breathlessness or weakness, immediately stop all activity and consult your physician.
Do not exercise if the blood pressure is uncontrolled, though this is beneficial for those having controlled BP.
If you are a diabetic on treatment with hypoglycaemic drugs or insulin injections; always carry a packet of sugar to tackle any hypoglycemic situation that may arise during exercise.
Testing your limits of tolerance serves no purpose and can be dangerous in old age.
Exercise either before meals or two hours after, never on full stomach because most of the blood is diverted for digestion and not enough is left for use of the heart.
This article is also published in India Study Channel
Persistently sedentary life is associated with significantly higher risk of mortality particularly from heart disease. The risk is even greater if chronic diseases like hypertension and diabetes co exist.
The level of physical fitness can be enhanced by a physically active lifestyle and regular exercise.
The reduction of risk has no relation with the basic fitness level; hence even though anyone has not been active in the past, will gain by physical activity.
How one can gain from physical exercise?
*Physical exercise burns excess calories and keeps body weight to healthy level.
*Keeps the blood sugar
at normal level.
*Improves lipid (fat) profile of blood by elevating the level of good cholesterol (HDL) and lowering the level of bad cholesterol (LDL).
*Lowers blood pressure.
Chance of thrombosis in the arteries of heart, brain, legs, etc. are reduced to a great extant.
*Improves the function of the lungs by opening up air spaces, improving oxygenation of blood and getting rid of excess secretions and phlegm.
*Heart function is also improved by increasing flow of blood in the coronary arteries which prevents build-up of cholesterol deposits, and opens up dormant collateral blood vessels which act as bypasses if arterial obstruction develops.
*Exercising also reduce likelihood of rhythm disturbances of the heart, thus reducing the risk of cardiac arrest.
*General improvement of metabolism and strengthening of immune system, which helps prevent/fight infections and even cancers.
What is the fitness level desired?
Excessive exercise produces oxidative stress and actually may harm; particularly for the elderly.
What is needed is regular exercise of moderate intensity and a physically active lifestyle, so that in course of time you are able to walk at full speed (120 steps per minute) for 20 minutes continuously and cover a distance of one mile (1.6 km) without difficulty.
For a sedentary person, it may require a few months of regular exercise to reach this stage of fitness; allow it to take its own time.
How much one should exercise?
Exercise should be strong enough to produce a bit of rapid breathing and sweating with 70-80 per cent of age-adjusted maximal heart (pulse) rate. Keep up the activity for 20-30 minutes four or five times a week. Before and after exercise there should be warm-up and cool-down periods of a few minutes each.
To arrive at your age-adjusted maximal heart rate subtract your age in years from 220. Thus a t age 50, your maximal heart rate is 220-50=170. You should therefore be exercising to produce a heart rate of 70-80 per cent of 170, i.e. 119 to 136 per minute.
What are the types of exercises we can easily do?
The exercises should be such as to involve large muscle masses like:
• walking,
• dancing,
• swimming,
• cycling, etc.
During and after middle age, walking is the best form of exercise. In old age it is almost the only exercise that one should perform.
All competitive activities should stop by the age of 35. After that, the games may be played only with the idea of fun and exercise.
Modern gadgets don’t offer added advantage except you can do it at your home at your own pace.
To be effective, exercise must be continued for progressively longer periods each week till it can be maintained for 20-30 minutes continuously.
Alternative approach is to accumulate daily activity in segments of 10 minutes each to a total of 30 minutes as described later in the article.
The slow progression is particularly important for the elderly, those unaccustomed to exercise and those with evidence of hypertension, diabetes or heart disease.
The long-term aim is to reach and maintain a minimum level of physical fitness.
Good effects on blood pressure, blood sugar, heart disease, body weight, etc., take time to appear and full effect takes almost one year. Once the effects are felt, it is important to maintain the same level of exercise and not become complacent.
How one can incorporate one’s lifestyle with physical activity?
There are numerous ways in which you can integrate physical activity in your daily life, such as:
• use stairs and not the lift to go upstairs,
• use a cycle instead of a car for distances less than 5 km.
• go to the market on foot or cycle, etc.
• perform household chores yourself such as cleaning the house, making beds, washing clothes.
Accumulated Daily Activity Programme
Practical recommendations of the expert panel of US Institute of Health may suit sedentary persons who find it difficult to allot time for regular exercise:
“All children and adults should gradually build 30 minutes of physical activity of moderate intensity (walking, climbing stairs, gardening, cycling.) on most preferably all, days of the week.”
These 30 minutes can be accumulated through segments of 10 minutes duration.
What are the precautions before starting any exercise program?
Consult your physician before staring exercising
• If you are 40 (men) or 50 (women).
• You have risk factors such as hypertension, diabetes, smoking, etc.
• If you have evidence of ischaemic heart disease or any other disease affecting major organs.
The exercise should be such that it produces a pleasant sense of tiredness which disappears after a little rest.
If you experience any adverse symptoms such as tightness or pain in the chest, undue breathlessness or weakness, immediately stop all activity and consult your physician.
Do not exercise if the blood pressure is uncontrolled, though this is beneficial for those having controlled BP.
If you are a diabetic on treatment with hypoglycaemic drugs or insulin injections; always carry a packet of sugar to tackle any hypoglycemic situation that may arise during exercise.
Testing your limits of tolerance serves no purpose and can be dangerous in old age.
Exercise either before meals or two hours after, never on full stomach because most of the blood is diverted for digestion and not enough is left for use of the heart.
This article is also published in India Study Channel
Thursday, February 19, 2009
Obesity management dieting principle
How fat deposited
Obesity is the result of overeating and physical inactivity. The unutilized calories are converted into fat and deposited in the fat depots of the body located in the abdomen and under the skin. The result of this is bulging abdomen and bloated body. Being ready sources of energy, fats and sugar are quickly converted into body fat in the event of their non-utilization.
Principles of dieting
While it is important to lower the total calorie intake, most of this reduction should be from the sugar and fats, i.e. sweets, sweet dishes, ice creams, ghee, butter and edible oils, as well as red meat and egg yolk. All fried food and junk food are therefore prohibited.
If you take non-vegetarian diet, change over to partial vegetarianism, so that you are taking animal food no more than l/3rd of plant food. Changeover should be gradual, because too much fiber too soon may produce abdominal discomfort. Increase the consumption of high fiber foods such as grains and beans gradually, especially in the evenings.
Do not skip meals; 'No fast and No feast' is the best policy.
Ensure variety of foods. It keeps the diet well balanced.
Remain physically active and exercise regularly.
Exercise burns calories by stimulating metabolism and the effect continues for many hours after exercise. It builds muscles too and will compensate for any muscle loss that may occur as a result of dieting.
Aim to reduce 1-2 kg per month. Do not take crash diets or hasten the process of weight reduction; it is unhealthy.
Weight once lost should not be regained. Going down the weighing scale and then up leads to more fat accumulation at the expense of muscle.
Achieve Satiety without Overeating
*No dieting is possible on a hungry stomach; you have to fill the stomach in such a way that you eat fewer calories.
*Eat plenty of raw vegetables, salads and fruit; they provide bulk, vitamins and minerals but they are low in calories.
*Drink plenty of water or diluted unsweetened buttermilk (lassi) before and during meals.
Change the style of eating:
Eat slowly and chew well; it takes 20 minutes to achieve
satiety; if you eat fast, you will eat more. Take low-fat snacks between meals, such as fresh fruits, popcorn, chana, unsweetened biscuits, etc.; they prevent overeating at regular meals. Do not fast if it leads to overeating next day.
Do not deny yourself your favorite food completely, because they are fattening; occasionally indulge yourself. This will help you to stick to your dieting routine better.
Steps to be taken at childhood to prevent obesity:
It is now known that giving children cow's (or formula) milk in the first year of life increases the size and number of fat cells in the body. This results in obesity in adult life which becomes difficult to shed. Children should be given breast milk in the first year, adding fresh vegetables and fruits, but minimum of sugar, sweets and fat, at the appropriate time.
This article is also published in India Study Channel
Obesity is the result of overeating and physical inactivity. The unutilized calories are converted into fat and deposited in the fat depots of the body located in the abdomen and under the skin. The result of this is bulging abdomen and bloated body. Being ready sources of energy, fats and sugar are quickly converted into body fat in the event of their non-utilization.
Principles of dieting
While it is important to lower the total calorie intake, most of this reduction should be from the sugar and fats, i.e. sweets, sweet dishes, ice creams, ghee, butter and edible oils, as well as red meat and egg yolk. All fried food and junk food are therefore prohibited.
If you take non-vegetarian diet, change over to partial vegetarianism, so that you are taking animal food no more than l/3rd of plant food. Changeover should be gradual, because too much fiber too soon may produce abdominal discomfort. Increase the consumption of high fiber foods such as grains and beans gradually, especially in the evenings.
Do not skip meals; 'No fast and No feast' is the best policy.
Ensure variety of foods. It keeps the diet well balanced.
Remain physically active and exercise regularly.
Exercise burns calories by stimulating metabolism and the effect continues for many hours after exercise. It builds muscles too and will compensate for any muscle loss that may occur as a result of dieting.
Aim to reduce 1-2 kg per month. Do not take crash diets or hasten the process of weight reduction; it is unhealthy.
Weight once lost should not be regained. Going down the weighing scale and then up leads to more fat accumulation at the expense of muscle.
Achieve Satiety without Overeating
*No dieting is possible on a hungry stomach; you have to fill the stomach in such a way that you eat fewer calories.
*Eat plenty of raw vegetables, salads and fruit; they provide bulk, vitamins and minerals but they are low in calories.
*Drink plenty of water or diluted unsweetened buttermilk (lassi) before and during meals.
Change the style of eating:
Eat slowly and chew well; it takes 20 minutes to achieve
satiety; if you eat fast, you will eat more. Take low-fat snacks between meals, such as fresh fruits, popcorn, chana, unsweetened biscuits, etc.; they prevent overeating at regular meals. Do not fast if it leads to overeating next day.
Do not deny yourself your favorite food completely, because they are fattening; occasionally indulge yourself. This will help you to stick to your dieting routine better.
Steps to be taken at childhood to prevent obesity:
It is now known that giving children cow's (or formula) milk in the first year of life increases the size and number of fat cells in the body. This results in obesity in adult life which becomes difficult to shed. Children should be given breast milk in the first year, adding fresh vegetables and fruits, but minimum of sugar, sweets and fat, at the appropriate time.
This article is also published in India Study Channel
Obesity and its effect on health
Obesity, overweight or fattiness is a disease of affluence, caused by overeating and lack of physical activity. It is linked to so many serious conditions like hypertension, diabetes and heart attacks, that it becomes necessary to prevent it or cure it if it is present.
Normal Body Weight
A simplified formula is to consider maximum normal weight at a height of 5 feet as 55 kg for men and 52 kg for women, and add 2 kg per inch of extra height. Thus for a man of 5 feet 8 inches, his maximum weight should be 55 + (8 x 2) = 71 kg.
Indicators of Obesity
The best indicator of obesity and need for weight reduction is the girth of the abdomen because it is the abdominal collection of fat which is the most harmful. All you need is a measuring tape; measure at the level of the navel.
All men who have a girth of 94 cm (37 inches) and
women 80 cm (32 inches) should not add weight. At 102 cm (40 inches) for men and 88 cm (35 inches) for women adverse effects of obesity start appearing.
Corresponding figures for bodyweight are 10 per cent above maximum desirable weight. At this level weight reduction becomes mandatory.
Effects of obesity on Health
Effect of obesity on joints and ligaments:
Obesity is a vicious cycle of physical inactivity causing obesity and obesity leading to more inactivity. It perpetuates itself with the following ill effects on the body. The extra weight puts an extra load on your heart and lungs, making you breathless on exertion. Under the heavy weight of the body, the weight-bearing joints of the lower back, hips and knees start creaking and develop degenerative changes and osteoarthritis. The ligaments and muscles around the joints ache.
Obesity may lead to diabetes:
The extra fat makes your body insensitive to the action of insulin (insulin resistance). Insulin resistance leads to poor utilization of sugar, raising blood sugar levels and diabetes. Type 2 diabetes, which accounts for almost 95 per cent cases of diabetes in India, depends to a large extent on obesity for its appearance and perpetuation.
Obesity and the heart diseases:
Obesity elevates and aggravates blood pressure. The lipid profile of the obese is usually disturbed, leading to rise of blood cholesterol; this brings about early degeneration and fatty obstructions in the arteries of the heart and brain. Through its links with hypertension, diabetes and lipid abnormalities, obesity is an important risk factor for heart attacks.
The above mentioned conditions are just the tip of the iceberg. Innumerable diseases including psychiatric illness and cancers are either directly or, indirectly to obesity.
Even a 5 to 10 kg reduction in body weight has a marked beneficial effect on health. Calorie Reduction Required to lose Weight. Each gram of fat is equal to 9 calories. To lose one kg of fat, you have to forego 9000 calories, i.e., 300 calories per day for one month. If you are a sedentary person but physically active, you need about 25 calories per kg of ideal (not actual) body weight to maintain yourself. If you consume 20 calories per kg of body weight and remain physically active, you will lose weight at the rate of about 1 – 1 ½ kg per month. Do not lower the intake below 1200 calories; the body metabolism will be slowed down and it will be counterproductive.
This article is also published in India Study Channel
Normal Body Weight
A simplified formula is to consider maximum normal weight at a height of 5 feet as 55 kg for men and 52 kg for women, and add 2 kg per inch of extra height. Thus for a man of 5 feet 8 inches, his maximum weight should be 55 + (8 x 2) = 71 kg.
Indicators of Obesity
The best indicator of obesity and need for weight reduction is the girth of the abdomen because it is the abdominal collection of fat which is the most harmful. All you need is a measuring tape; measure at the level of the navel.
All men who have a girth of 94 cm (37 inches) and
women 80 cm (32 inches) should not add weight. At 102 cm (40 inches) for men and 88 cm (35 inches) for women adverse effects of obesity start appearing.
Corresponding figures for bodyweight are 10 per cent above maximum desirable weight. At this level weight reduction becomes mandatory.
Effects of obesity on Health
Effect of obesity on joints and ligaments:
Obesity is a vicious cycle of physical inactivity causing obesity and obesity leading to more inactivity. It perpetuates itself with the following ill effects on the body. The extra weight puts an extra load on your heart and lungs, making you breathless on exertion. Under the heavy weight of the body, the weight-bearing joints of the lower back, hips and knees start creaking and develop degenerative changes and osteoarthritis. The ligaments and muscles around the joints ache.
Obesity may lead to diabetes:
The extra fat makes your body insensitive to the action of insulin (insulin resistance). Insulin resistance leads to poor utilization of sugar, raising blood sugar levels and diabetes. Type 2 diabetes, which accounts for almost 95 per cent cases of diabetes in India, depends to a large extent on obesity for its appearance and perpetuation.
Obesity and the heart diseases:
Obesity elevates and aggravates blood pressure. The lipid profile of the obese is usually disturbed, leading to rise of blood cholesterol; this brings about early degeneration and fatty obstructions in the arteries of the heart and brain. Through its links with hypertension, diabetes and lipid abnormalities, obesity is an important risk factor for heart attacks.
The above mentioned conditions are just the tip of the iceberg. Innumerable diseases including psychiatric illness and cancers are either directly or, indirectly to obesity.
Even a 5 to 10 kg reduction in body weight has a marked beneficial effect on health. Calorie Reduction Required to lose Weight. Each gram of fat is equal to 9 calories. To lose one kg of fat, you have to forego 9000 calories, i.e., 300 calories per day for one month. If you are a sedentary person but physically active, you need about 25 calories per kg of ideal (not actual) body weight to maintain yourself. If you consume 20 calories per kg of body weight and remain physically active, you will lose weight at the rate of about 1 – 1 ½ kg per month. Do not lower the intake below 1200 calories; the body metabolism will be slowed down and it will be counterproductive.
This article is also published in India Study Channel
Wednesday, February 18, 2009
How infection occurs and how to prevent infections?
To learn to protect ourselves from infections we must at first know what are the different ways, we can get infected? The disease producing microorganisms must reach our bodies before they can cause infection and disease. They take one or more of the following routes to reach us.
Routes of Infection
• To the mouth through food and drink.
• To the respiratory tract and lungs through the infected air coughed out by a patient.
• By skin contact. Normally our skin acts as an efficient barrier against infection, but if our hands get infected and we eat with dirty hands or touch sensitive parts like the eyes, we can transmit disease.
• Sexual contact.
• Through cuts and wounds.
• Infected injections or blood transfusion.
• Animal vectors such as mosquitoes and housefly transmit infection, e.g. housefly may sit on the excreta of a patient of cholera and then sit on food and infect it. Mosquito may acquire the malarial parasite by biting a patient of malaria, and then bite a healthy person and inject the parasite into him.
Let us now see how we can destroy the microorganisms, responsible for the infections.There are various ways of destroying the microbes.
Fire and heating at high temperatures, such as boiling for 10 – 15 minutes kill most of the common microbes.
Chemical disinfectants such as methylated spirit, carbolic acid, Savlon, etc., kill microorganisms. These chemicals, called antiseptics, can be used to our advantage. Any chemical which kills germs, a form of life, can be harmful to our health. Use of antiseptics has therefore to be judicious and external only.
Low temperatures stop the growth and multiplication of bacteria but does not kill them. Hence food left in the refrigerator remains fresh for a long time, provided it is not already infected.
Water filters: candle filters are reasonably effective to filter off bacteria and suspended impurities but they permit viruses to pass through. If a water-borne virus epidemic, such as infective jaundice, is raging, these filters are ineffective. Boiling the filtered water is safe.
Electric water purifiers are probably effective but need constant maintenance which is costly and not always available. Reverse osmosis technology is nowadays available at moderate price is quite effective for removing bacteriae and viruses.
Animal vectors, the carriers of infection, such as mosquitoes and housefly are eliminated by chemical sprays of insecticides, or their entry is prevented by wire-gauze shuttering or mosquito nets.
Personal precaution at home, work or travel will help us to prevent infection. Most of the things we know from our childhood but forget to implement. Just to refresh our knowledge regarding our self protection read the following points:
Personal Precautions At home:
• Wash your hands with soap and water every time you have to touch or eat food.
• Filter the water supplied by your municipality. Boil the filtered water if there is an epidemic of water-borne diseases such as cholera, gastroenteritis and infective jaundice.
• Do not let the food stand outside for any length of time before storing in the refrigerator, because at room temperature even small number of organisms will multiply to large numbers.
• Wash and clean the vegetables before storing in the refrigerator.
• Do not buy fruit, such as watermelon, which has been cut and exposed to flies.
• Disinfect the food, especially animal food such as milk and chicken by boiling before storing in the fridge.
• In the course of daily contact with people, you have to shake hands with them. Fortunately, Indian social customs forbid social kissing. Do not touch any delicate part of your body nor your food without first washing your hands with soap and water. If a guest has used the WC seat, clean it with antiseptic lotion before use.
• Do not allow others to use your personal clothing nor should you use theirs.
• Every member of the family should use separate towel for bathing.
• Linen and towels used by guests should be used only after proper washing and drying in the sun. In all doubtful cases, they should be sterilized by antiseptic lotion or by boiling in water.
• Keep your house free from mosquitoes and houseflies. Do not keep stagnant pools of water in or near your house; they breed mosquitoes.
• Change water of desert coolers every seven days; this will ensure that mosquitoes do not breed in them, because it takes ten days for the eggs to become larvae and then adult mosquitoes.
• Use insecticide sprays or fumes when necessary, but avoid unnecessary exposure to them. After the spray has acted for about half an hour, open the doors and windows wide open, but keeping the wire-gauze shutters in place, so as to let out the poisonous chemicals.
Personal precaution at work:
• While using a WC, either remove the seat with your toe (not ringer) and use the WC in the Indian style by squatting on it, or sterilize the seat with an antiseptic lotion before sitting on it. Alternatively, place a sheet of paper or newspaper between you and the seat, so that there is no direct contact between you and the seat.
• Take filtered and boiled water with you in a bottle for consumption at the workplace.
• Hot beverages like tea and coffee may be prepared and consumed in the office.
Personal protection while traveling:
• Take your own set of towels, two bed sheets and a pillow cover for each person.
• Use your own towels unless disposable towels are provided.
• Avoid food which has not come directly from the fire,
• such as salads.
• Do not drink hotel water; drink mineral water or reliable soft drinks directly from the bottles, if possible.
Miscellaneous precautions:
• If you have an infectious patient in the house, nurse him in a separate room, observing all common sense precautions such as not permitting children into the sick room.
• If you visit a friend who is ill, be careful to sit at a distance, especially if he is coughing or sneezing. Always wash your hands with soap and water when you come out of the sick room.
• When going out to attend functions, marriages or parties, load yourself with water. If you are thirsty, drink straight from a bottle of a reliable soft drink or mineral water; do not use tumbler which is rarely washed properly at functions.
• If there is a cut or wound, do not give time to micro¬ organisms to multiply and grow in numbers. Immediately, clean the area with an antiseptic such as methylated spirit and apply clean dressing such as Band-Aid. Take care not to touch the inside dressing material with your fingers, even though they have been washed with soap and water.
• Confine your sexual activity to the marital bed. If both the spouses are faithful to each other, the serious sexually transmitted diseases such as AIDS and syphilis are avoided.
• Many of the serious infections such as AIDS, Hepatitis B and C can be transmitted through injections an infected syringe and needle. Either
• Pre-sterilized disposable syringe and needle, or boil the glass syringe and needle for fifteen minutes before allowing yourself to be injected with it. The above mentioned infections can be transmitted through infected blood transfusion or injection of infected blood products. If a blood transfusion is to be given to you or any family member, always get certified blood from a reliable laboratory.
This article is also published in India Study Channel
Routes of Infection
• To the mouth through food and drink.
• To the respiratory tract and lungs through the infected air coughed out by a patient.
• By skin contact. Normally our skin acts as an efficient barrier against infection, but if our hands get infected and we eat with dirty hands or touch sensitive parts like the eyes, we can transmit disease.
• Sexual contact.
• Through cuts and wounds.
• Infected injections or blood transfusion.
• Animal vectors such as mosquitoes and housefly transmit infection, e.g. housefly may sit on the excreta of a patient of cholera and then sit on food and infect it. Mosquito may acquire the malarial parasite by biting a patient of malaria, and then bite a healthy person and inject the parasite into him.
Let us now see how we can destroy the microorganisms, responsible for the infections.There are various ways of destroying the microbes.
Fire and heating at high temperatures, such as boiling for 10 – 15 minutes kill most of the common microbes.
Chemical disinfectants such as methylated spirit, carbolic acid, Savlon, etc., kill microorganisms. These chemicals, called antiseptics, can be used to our advantage. Any chemical which kills germs, a form of life, can be harmful to our health. Use of antiseptics has therefore to be judicious and external only.
Low temperatures stop the growth and multiplication of bacteria but does not kill them. Hence food left in the refrigerator remains fresh for a long time, provided it is not already infected.
Water filters: candle filters are reasonably effective to filter off bacteria and suspended impurities but they permit viruses to pass through. If a water-borne virus epidemic, such as infective jaundice, is raging, these filters are ineffective. Boiling the filtered water is safe.
Electric water purifiers are probably effective but need constant maintenance which is costly and not always available. Reverse osmosis technology is nowadays available at moderate price is quite effective for removing bacteriae and viruses.
Animal vectors, the carriers of infection, such as mosquitoes and housefly are eliminated by chemical sprays of insecticides, or their entry is prevented by wire-gauze shuttering or mosquito nets.
Personal precaution at home, work or travel will help us to prevent infection. Most of the things we know from our childhood but forget to implement. Just to refresh our knowledge regarding our self protection read the following points:
Personal Precautions At home:
• Wash your hands with soap and water every time you have to touch or eat food.
• Filter the water supplied by your municipality. Boil the filtered water if there is an epidemic of water-borne diseases such as cholera, gastroenteritis and infective jaundice.
• Do not let the food stand outside for any length of time before storing in the refrigerator, because at room temperature even small number of organisms will multiply to large numbers.
• Wash and clean the vegetables before storing in the refrigerator.
• Do not buy fruit, such as watermelon, which has been cut and exposed to flies.
• Disinfect the food, especially animal food such as milk and chicken by boiling before storing in the fridge.
• In the course of daily contact with people, you have to shake hands with them. Fortunately, Indian social customs forbid social kissing. Do not touch any delicate part of your body nor your food without first washing your hands with soap and water. If a guest has used the WC seat, clean it with antiseptic lotion before use.
• Do not allow others to use your personal clothing nor should you use theirs.
• Every member of the family should use separate towel for bathing.
• Linen and towels used by guests should be used only after proper washing and drying in the sun. In all doubtful cases, they should be sterilized by antiseptic lotion or by boiling in water.
• Keep your house free from mosquitoes and houseflies. Do not keep stagnant pools of water in or near your house; they breed mosquitoes.
• Change water of desert coolers every seven days; this will ensure that mosquitoes do not breed in them, because it takes ten days for the eggs to become larvae and then adult mosquitoes.
• Use insecticide sprays or fumes when necessary, but avoid unnecessary exposure to them. After the spray has acted for about half an hour, open the doors and windows wide open, but keeping the wire-gauze shutters in place, so as to let out the poisonous chemicals.
Personal precaution at work:
• While using a WC, either remove the seat with your toe (not ringer) and use the WC in the Indian style by squatting on it, or sterilize the seat with an antiseptic lotion before sitting on it. Alternatively, place a sheet of paper or newspaper between you and the seat, so that there is no direct contact between you and the seat.
• Take filtered and boiled water with you in a bottle for consumption at the workplace.
• Hot beverages like tea and coffee may be prepared and consumed in the office.
Personal protection while traveling:
• Take your own set of towels, two bed sheets and a pillow cover for each person.
• Use your own towels unless disposable towels are provided.
• Avoid food which has not come directly from the fire,
• such as salads.
• Do not drink hotel water; drink mineral water or reliable soft drinks directly from the bottles, if possible.
Miscellaneous precautions:
• If you have an infectious patient in the house, nurse him in a separate room, observing all common sense precautions such as not permitting children into the sick room.
• If you visit a friend who is ill, be careful to sit at a distance, especially if he is coughing or sneezing. Always wash your hands with soap and water when you come out of the sick room.
• When going out to attend functions, marriages or parties, load yourself with water. If you are thirsty, drink straight from a bottle of a reliable soft drink or mineral water; do not use tumbler which is rarely washed properly at functions.
• If there is a cut or wound, do not give time to micro¬ organisms to multiply and grow in numbers. Immediately, clean the area with an antiseptic such as methylated spirit and apply clean dressing such as Band-Aid. Take care not to touch the inside dressing material with your fingers, even though they have been washed with soap and water.
• Confine your sexual activity to the marital bed. If both the spouses are faithful to each other, the serious sexually transmitted diseases such as AIDS and syphilis are avoided.
• Many of the serious infections such as AIDS, Hepatitis B and C can be transmitted through injections an infected syringe and needle. Either
• Pre-sterilized disposable syringe and needle, or boil the glass syringe and needle for fifteen minutes before allowing yourself to be injected with it. The above mentioned infections can be transmitted through infected blood transfusion or injection of infected blood products. If a blood transfusion is to be given to you or any family member, always get certified blood from a reliable laboratory.
This article is also published in India Study Channel
Cancers - An Overview
Almost 25 per cent of all deaths due to non-infectious and non-accidental causes occur due to cancer. Next to heart attacks, this is the biggest killer of mankind. It is usually a disease of middle age and beyond, though some childhood cancers do occur. The treatment is generally surgical which may be combined with chemotherapy and / or radiotherapy. Successful outcome depends on early detection and diagnosis. Once it has spread beyond the confines of the original tumor, radical cure becomes less likely, though palliative treatment is still possible.
What is Cancer?
Cancer consists of cells which have turned malignant. They start growing and multiplying at the cost of normal tissues, destroying the latter in the process. While innocent or benign tumors may show little growth over months or years, cancers have the property of enormously rapid growth.
In a matter of a few months, they may enlarge substantially. They also have the property of invading and spreading into the nearby lymph glands and to distant organs as secondary growths which are as malignant as the original tumor. An innocent tumor does not possess these lethal characteristics unless a malignant change occurs in it.
The ultimate diagnosis of malignancy /cancer or, innocence of the tumor depends in biopsy. Biopsy consists of taking out a piece of the suspected tissue which is then examined by a pathologist under the microscope.
Where can Cancer Appear?
A typical feature of cancer is its lack of pain and inflammation at early stages. It is important to recognize the fact that in early stages the swelling or mass, despite of its size and rapid growth is painless. No pain is produced even on pressure. No sign of inflammation like heat, or redness is found. On should not ignore any swelling if it is painless.
Tumors, including cancers, may appear on the visible surfaces like the skin, breast or penis, where they are open to inspection.
They may arise from one of the internal organs like the lung, kidney, prostate, ovary, brain, liver, etc.When arising from internal organs, cancer cannot be seen or felt but can be suspected from the symptoms it produces.
Warning Signals of cancers:
• Unusual bleeding or discharge from any internal or external body site.
• A lump or thickening in any area but especially the breast.
• A sore that does not heal.
• A change in bowel or bladder habits.
• Hoarseness of voice.
• Persistent cough.
• Indigestion and difficulty in swallowing.
• Change in the appearance, shape or size of a wart or mole.
• Unexplained loss of appetite.
• Unexplained fever.
• Unexplained loss of weight.
Am I having cancer?
• Successful outcome of treatment solely depends on one single factor—the earliest possible detection and diagnosis. Anyone with any of these following symptoms should visit the doctor immediately for check up.
• A mass on the visible surface like skin, breast, penis, etc. Or, a sore which is not healing.
• The mass is growing in size but painless.
• Any mass or masses (glands) in the neck, armpits, groins or elsewhere.
• Low grade fever, without obvious cause and which shows no sign of remitting.
• Unaccounted loss of weight and general weakness, i.e. without dieting or poor intake of food.
• Cough or breathlessness or cyanosis (blue tongue) without obvious cause.
• Persistent headache with vomiting without previous history of migraine or cluster headaches.
• Spitting of blood.
• Loss of appetite, not caused by such factors as drugs / medicines .
• Black tar-like stools or red blood from anus, not due to piles.
• Blood in urine.
• Irregular vaginal bleeding, at or after menopause.
Investigations done to diagnose cancer:
Clinical examination by the surgeon.
Laboratory investigations, like X-rays, barium meal test, endoscopy, intravenous pyelogram, ultrasonography, CAT scan, etc., are selected according to the site of the suspected growth.
Assay of different tumor markers
Ultimate test is biopsy without which it may not be possible to say if the growth is malignant or innocent.
It is comparatively easy to obtain a specimen from accessible sites such as the breast, but in the case of internal organs FNAC ( fine needle aspiration cytology) gives the idea about the nature the tumor. If suspected the patient is operated upon to remove the mass or, to have a proper biopsy from the site.
Prevention of cancers:
• All sources of chronic irritation, e.g. broken stumps of teeth, should be removed.
• Avoid application of chemicals to the skin.
• No smoking.
• Eat plenty of fresh vegetables and fruits; they are rich sources of anti-oxidants which prevent cancers and many other diseases of degeneration.
• Regular self examination of the breast.
• Women should have regular PAP smear of the cervix after the age of 35 at least once in 2 years.
• Gardasyl a vaccine has been launched recently to protect the women from cervical cancers.
This article is published in India Study Channel
What is Cancer?
Cancer consists of cells which have turned malignant. They start growing and multiplying at the cost of normal tissues, destroying the latter in the process. While innocent or benign tumors may show little growth over months or years, cancers have the property of enormously rapid growth.
In a matter of a few months, they may enlarge substantially. They also have the property of invading and spreading into the nearby lymph glands and to distant organs as secondary growths which are as malignant as the original tumor. An innocent tumor does not possess these lethal characteristics unless a malignant change occurs in it.
The ultimate diagnosis of malignancy /cancer or, innocence of the tumor depends in biopsy. Biopsy consists of taking out a piece of the suspected tissue which is then examined by a pathologist under the microscope.
Where can Cancer Appear?
A typical feature of cancer is its lack of pain and inflammation at early stages. It is important to recognize the fact that in early stages the swelling or mass, despite of its size and rapid growth is painless. No pain is produced even on pressure. No sign of inflammation like heat, or redness is found. On should not ignore any swelling if it is painless.
Tumors, including cancers, may appear on the visible surfaces like the skin, breast or penis, where they are open to inspection.
They may arise from one of the internal organs like the lung, kidney, prostate, ovary, brain, liver, etc.When arising from internal organs, cancer cannot be seen or felt but can be suspected from the symptoms it produces.
Warning Signals of cancers:
• Unusual bleeding or discharge from any internal or external body site.
• A lump or thickening in any area but especially the breast.
• A sore that does not heal.
• A change in bowel or bladder habits.
• Hoarseness of voice.
• Persistent cough.
• Indigestion and difficulty in swallowing.
• Change in the appearance, shape or size of a wart or mole.
• Unexplained loss of appetite.
• Unexplained fever.
• Unexplained loss of weight.
Am I having cancer?
• Successful outcome of treatment solely depends on one single factor—the earliest possible detection and diagnosis. Anyone with any of these following symptoms should visit the doctor immediately for check up.
• A mass on the visible surface like skin, breast, penis, etc. Or, a sore which is not healing.
• The mass is growing in size but painless.
• Any mass or masses (glands) in the neck, armpits, groins or elsewhere.
• Low grade fever, without obvious cause and which shows no sign of remitting.
• Unaccounted loss of weight and general weakness, i.e. without dieting or poor intake of food.
• Cough or breathlessness or cyanosis (blue tongue) without obvious cause.
• Persistent headache with vomiting without previous history of migraine or cluster headaches.
• Spitting of blood.
• Loss of appetite, not caused by such factors as drugs / medicines .
• Black tar-like stools or red blood from anus, not due to piles.
• Blood in urine.
• Irregular vaginal bleeding, at or after menopause.
Investigations done to diagnose cancer:
Clinical examination by the surgeon.
Laboratory investigations, like X-rays, barium meal test, endoscopy, intravenous pyelogram, ultrasonography, CAT scan, etc., are selected according to the site of the suspected growth.
Assay of different tumor markers
Ultimate test is biopsy without which it may not be possible to say if the growth is malignant or innocent.
It is comparatively easy to obtain a specimen from accessible sites such as the breast, but in the case of internal organs FNAC ( fine needle aspiration cytology) gives the idea about the nature the tumor. If suspected the patient is operated upon to remove the mass or, to have a proper biopsy from the site.
Prevention of cancers:
• All sources of chronic irritation, e.g. broken stumps of teeth, should be removed.
• Avoid application of chemicals to the skin.
• No smoking.
• Eat plenty of fresh vegetables and fruits; they are rich sources of anti-oxidants which prevent cancers and many other diseases of degeneration.
• Regular self examination of the breast.
• Women should have regular PAP smear of the cervix after the age of 35 at least once in 2 years.
• Gardasyl a vaccine has been launched recently to protect the women from cervical cancers.
This article is published in India Study Channel
Tuesday, February 17, 2009
Facts about cholesterol
Cholesterol is a major factor for occurrence of heart attacks. It is the main component of atheroma. Atheroma is the fatty deposit in the arterial walls that blocks them and obstructs the flow of blood in them. Cholesterol is a sterol, manufactured in the liver., is a normal constituent of the cells of animals including man
Source of cholesterol in food:
Cholesterol is found in animal tissues in abundance like liver, kidneys, brain, egg yolks. Animal fats such as ghee, butter, lard, suet and cream are also rich sources of cholesterol.
Plants do not manufacture cholesterol and all plant food and vegetable oils are devoid of cholesterol. Nuts and seeds do not contain cholesterol.
The level of our blood cholesterol depends upon our diet, in addition to that manufactured by our liver.
Cholesterol in the Blood
Cholesterol circulates in the blood in combination with lipoproteins of varying densities. Low and very low density cholesterol (LDL and VLDL) is bad cholesterol because it produces atheroma and clogs the arteries. High density lipoprotein cholesterol or HDL is good cholesterol as it reduces the amount of bad cholesterol in the blood and prevents its deposition in the arteries. Physical activity and exercise raise the level of HDL in the blood. Small amounts of alcohol also raise HDL levels.
By burning off cholesterol, like any other fat, exercise lowers the level of total blood cholesterol. Saturated fats (ghee, butter, margarine, vegetable ghee) increase the level of bad cholesterol, LDL and total cholesterol by stimulating its production by the body.
Cigarette smoking, laziness and physical inactivity lower the good cholesterol and raise the bad cholesterol and are therefore risk factors for the heart. Overuse of cars and scooters is an important reason for our inactivity and laziness and the consequent rise in blood cholesterol levels, and the resultant rise in the incidence of heart attacks.
Normal Levels of Blood Cholesterol
Cholesterol (total): 130-220 mg/dl
HDL-cholesterol: 30-90 mg/dl
LDL-cholesterol: Total cholesterol minus HDL
Total cholesterol: HDL ratio: up to 4
Triglycerides (neutral fats): up 200 mg%
How to Lower Cholesterol Levels
• Diet - generally vegetarian; fish is an advantage.
• Increased physical activity and regular exercise.
• Consumption of vegetable oils which do not solidify in winter, such as mustard oil, soya bean oil, corn oil, in preference to animal fats.
• Restrict the use of ghee in application to chapattis and butter to toasts.
• Avoid eggs, organ meat (brain, liver, kidneys).
• Stop smoking to raise the good cholesterol HDL.
If after a trial of 6 months, the blood cholesterol levels do not fall below 220 mg per cent, preferably 200 mg per cent, the question of instituting cholesterol-lowering drugs like Lovastatin may have to be considered by your physician.
In case the initial level is very high, e.g. 300 mg per cent, Lovastatin may have to be started immediately along with the low cholesterol diet.
This article is also published in India Study Channel
Source of cholesterol in food:
Cholesterol is found in animal tissues in abundance like liver, kidneys, brain, egg yolks. Animal fats such as ghee, butter, lard, suet and cream are also rich sources of cholesterol.
Plants do not manufacture cholesterol and all plant food and vegetable oils are devoid of cholesterol. Nuts and seeds do not contain cholesterol.
The level of our blood cholesterol depends upon our diet, in addition to that manufactured by our liver.
Cholesterol in the Blood
Cholesterol circulates in the blood in combination with lipoproteins of varying densities. Low and very low density cholesterol (LDL and VLDL) is bad cholesterol because it produces atheroma and clogs the arteries. High density lipoprotein cholesterol or HDL is good cholesterol as it reduces the amount of bad cholesterol in the blood and prevents its deposition in the arteries. Physical activity and exercise raise the level of HDL in the blood. Small amounts of alcohol also raise HDL levels.
By burning off cholesterol, like any other fat, exercise lowers the level of total blood cholesterol. Saturated fats (ghee, butter, margarine, vegetable ghee) increase the level of bad cholesterol, LDL and total cholesterol by stimulating its production by the body.
Cigarette smoking, laziness and physical inactivity lower the good cholesterol and raise the bad cholesterol and are therefore risk factors for the heart. Overuse of cars and scooters is an important reason for our inactivity and laziness and the consequent rise in blood cholesterol levels, and the resultant rise in the incidence of heart attacks.
Normal Levels of Blood Cholesterol
Cholesterol (total): 130-220 mg/dl
HDL-cholesterol: 30-90 mg/dl
LDL-cholesterol: Total cholesterol minus HDL
Total cholesterol: HDL ratio: up to 4
Triglycerides (neutral fats): up 200 mg%
How to Lower Cholesterol Levels
• Diet - generally vegetarian; fish is an advantage.
• Increased physical activity and regular exercise.
• Consumption of vegetable oils which do not solidify in winter, such as mustard oil, soya bean oil, corn oil, in preference to animal fats.
• Restrict the use of ghee in application to chapattis and butter to toasts.
• Avoid eggs, organ meat (brain, liver, kidneys).
• Stop smoking to raise the good cholesterol HDL.
If after a trial of 6 months, the blood cholesterol levels do not fall below 220 mg per cent, preferably 200 mg per cent, the question of instituting cholesterol-lowering drugs like Lovastatin may have to be considered by your physician.
In case the initial level is very high, e.g. 300 mg per cent, Lovastatin may have to be started immediately along with the low cholesterol diet.
This article is also published in India Study Channel
Causes and remedies of headache
Though nervous system is rarely involved in a case of headache, but it is wise to exclude any association with nervous system in long standing and, or undiagnosed headache. If timely diagnosed, headache due to neurological reasons like brain tumor, meningitis, or, hemorrhage can be reverted.
In the following type of headaches seek medical advice promptly when headache is:
*Persistent
*Occurs after head injury, even though minor
*Associated with loss of consciousness or change in consciousness,
*Associated with convulsions, disturbed brain function of memory, orientation, speech, etc.
*Associated with paralysis of any kind,
*Associated with seeing double images; failing vision,
*Associated with fever,
*Associated with vomiting.
Other Common (Non Serious) Causes of Headache:
Tension headache
This is the commonest cause of headache. Factors responsible are stress and strain of modern life, hurrying, racing against time, worries and anxieties, insomnia.
Remedy of Tension Headache:
Tranquilizers help to relieve temporarily but changing the lifestyle should be given utmost importance. Yoga and meditation help immensely to tide over tensions.
Hunger and irregular food intake:
Another important cause of headache is long gap between meals. This tends to lower the blood sugar level and may result in headache.
Remedy
Take food at regular intervals.
Sinusitis
Spaces within the bones around the nasal cavity are called paranasal sinuses; they communicate with the nasal cavity. Inflammation of frontal sinus, located in the forehead is common after common cold. Communication with the nasal cavity is blocked due to inflammation and the air within the sinus is absorbed. A large difference of air pressure inside and outside the sinus results and causes severe headache and vomiting.
Remedy
Steam inhalations help. Sit with your head about two feet above a steaming electric kettle for 10-20 minutes. Blow through the nose as necessary. You will feel relieved as the passages open up.
Eye Strain
If you need glasses but do not wear them, headache may appear after a few hours of work. If you are not wearing proper glasses, especially when you are working on your computer, you can get a headache. It must be understood that the distance of the computer screen from your eyes is more than the reading distance for a book. If you have been prescribed reading glasses, you need a differently-powered glass for computer work.
As distinct from eye strain, beware of acute pain around one eye which could be due to acute glaucoma. This needs urgent diagnosis by an eye specialist. If the tension within the eye is found to be high, urgent operation may be necessary.
Migraine
Typically migraine presents as severe periodical throbbing headache, usually one-sided. Onset is sudden, with throbbing pain which reaches its peak in an hour or so, when nausea and vomiting also start. The attack may last for a few hours or a day or two. In some patients, the attack of headache is preceded by twinkling before the eyes, difficulty of speech, or numbness of lips, face and limbs and even temporary paralysis, but all these symptoms disappear in a few minutes. These symptoms, though recurrent and disturbing to the patient, do not cause permanent disability.
Other important features of migraine are: Frequency of attack is usually once in a few weeks, not daily. The attack may be provoked by alcoholic drinks (red wine in particular), sudden changes in temperatures, exposure to bright sunlight, stress at work, errors of refraction, certain food etc.
Treatment of Migraine
At the first indication of attack, a tablet of Paracetamol or Ergotamine, repeated after half an hour, if necessary. Ergotamine preparations should be taken only under medical supervision, not more than six tablets in a single attack and not to be taken during pregnancy. Sumatriptan Succinate, another preparation works very well, if taken prior to an established attack. Botox injection helps in intractable cases.
Avoid precipitating factors as far as practicable. Get your refraction corrected, reschedule your work to avoid tensions, and avoid any food that is found to consistently precipitate the attack.
Cluster Headaches
This causes a constant non-throbbing headaches on one side of the head.Though not connected with any disease of the eye, the pain is usually located in the region of the orbit of one eye, Cluster headache usually starts within two to three hours of falling asleep and infrequent during waking hours.
The pain is intense, steady and constant with flushing of face, blocked nose and tears from the eye. Pain may last an hour or so and then may leave as suddenly as it came. Pain tends to recur every night for several weeks or even months, hence the name 'cluster'. In between the clusters, there is complete freedom from headache, sometimes for years. Cluster may recur in times of stress, overwork or emotional upheavals. Alcoholic beverages and certain kinds of food may precipitate the headache during the cluster but not during the period of freedom from attacks. This causes no permanent disability.
Treatment of cluster headache
A tablet of Paracetamol for the headache, repeated if necessary. Ergotamine preparations, though reported to be effective, are best avoided because their number can reach dangerously high in a cluster. The anti-depressant drug amitryptaline (Tryptomer), given in a small dose at night, is safe and effective in interrupting a cluster.
High Blood Pressure
Contrary to usual belief, hypertension rarely causes headache. Nervous tension may cause both headache as well as elevation of blood pressure. Do not therefore depend on your feeling of headache to judge the level of your blood pressure but rely on actual readings taken with a mercury BP instrument.
Sudden severe rise of blood pressure, however, can cause severe headache and even cerebral haemorrhage. Then it needs to be urgently but carefully brought down to safer levels with the help of your doctor.
This article is republished at India Study channel
In the following type of headaches seek medical advice promptly when headache is:
*Persistent
*Occurs after head injury, even though minor
*Associated with loss of consciousness or change in consciousness,
*Associated with convulsions, disturbed brain function of memory, orientation, speech, etc.
*Associated with paralysis of any kind,
*Associated with seeing double images; failing vision,
*Associated with fever,
*Associated with vomiting.
Other Common (Non Serious) Causes of Headache:
Tension headache
This is the commonest cause of headache. Factors responsible are stress and strain of modern life, hurrying, racing against time, worries and anxieties, insomnia.
Remedy of Tension Headache:
Tranquilizers help to relieve temporarily but changing the lifestyle should be given utmost importance. Yoga and meditation help immensely to tide over tensions.
Hunger and irregular food intake:
Another important cause of headache is long gap between meals. This tends to lower the blood sugar level and may result in headache.
Remedy
Take food at regular intervals.
Sinusitis
Spaces within the bones around the nasal cavity are called paranasal sinuses; they communicate with the nasal cavity. Inflammation of frontal sinus, located in the forehead is common after common cold. Communication with the nasal cavity is blocked due to inflammation and the air within the sinus is absorbed. A large difference of air pressure inside and outside the sinus results and causes severe headache and vomiting.
Remedy
Steam inhalations help. Sit with your head about two feet above a steaming electric kettle for 10-20 minutes. Blow through the nose as necessary. You will feel relieved as the passages open up.
Eye Strain
If you need glasses but do not wear them, headache may appear after a few hours of work. If you are not wearing proper glasses, especially when you are working on your computer, you can get a headache. It must be understood that the distance of the computer screen from your eyes is more than the reading distance for a book. If you have been prescribed reading glasses, you need a differently-powered glass for computer work.
As distinct from eye strain, beware of acute pain around one eye which could be due to acute glaucoma. This needs urgent diagnosis by an eye specialist. If the tension within the eye is found to be high, urgent operation may be necessary.
Migraine
Typically migraine presents as severe periodical throbbing headache, usually one-sided. Onset is sudden, with throbbing pain which reaches its peak in an hour or so, when nausea and vomiting also start. The attack may last for a few hours or a day or two. In some patients, the attack of headache is preceded by twinkling before the eyes, difficulty of speech, or numbness of lips, face and limbs and even temporary paralysis, but all these symptoms disappear in a few minutes. These symptoms, though recurrent and disturbing to the patient, do not cause permanent disability.
Other important features of migraine are: Frequency of attack is usually once in a few weeks, not daily. The attack may be provoked by alcoholic drinks (red wine in particular), sudden changes in temperatures, exposure to bright sunlight, stress at work, errors of refraction, certain food etc.
Treatment of Migraine
At the first indication of attack, a tablet of Paracetamol or Ergotamine, repeated after half an hour, if necessary. Ergotamine preparations should be taken only under medical supervision, not more than six tablets in a single attack and not to be taken during pregnancy. Sumatriptan Succinate, another preparation works very well, if taken prior to an established attack. Botox injection helps in intractable cases.
Avoid precipitating factors as far as practicable. Get your refraction corrected, reschedule your work to avoid tensions, and avoid any food that is found to consistently precipitate the attack.
Cluster Headaches
This causes a constant non-throbbing headaches on one side of the head.Though not connected with any disease of the eye, the pain is usually located in the region of the orbit of one eye, Cluster headache usually starts within two to three hours of falling asleep and infrequent during waking hours.
The pain is intense, steady and constant with flushing of face, blocked nose and tears from the eye. Pain may last an hour or so and then may leave as suddenly as it came. Pain tends to recur every night for several weeks or even months, hence the name 'cluster'. In between the clusters, there is complete freedom from headache, sometimes for years. Cluster may recur in times of stress, overwork or emotional upheavals. Alcoholic beverages and certain kinds of food may precipitate the headache during the cluster but not during the period of freedom from attacks. This causes no permanent disability.
Treatment of cluster headache
A tablet of Paracetamol for the headache, repeated if necessary. Ergotamine preparations, though reported to be effective, are best avoided because their number can reach dangerously high in a cluster. The anti-depressant drug amitryptaline (Tryptomer), given in a small dose at night, is safe and effective in interrupting a cluster.
High Blood Pressure
Contrary to usual belief, hypertension rarely causes headache. Nervous tension may cause both headache as well as elevation of blood pressure. Do not therefore depend on your feeling of headache to judge the level of your blood pressure but rely on actual readings taken with a mercury BP instrument.
Sudden severe rise of blood pressure, however, can cause severe headache and even cerebral haemorrhage. Then it needs to be urgently but carefully brought down to safer levels with the help of your doctor.
This article is republished at India Study channel
Thursday, February 12, 2009
Managing Stress
How to Deal with Stress
Three ways to deal with stress are:
1. Avoid stress, if possible
2. Utilize stress to your advantage, if you can
3. Cope with stress to prevent disease
How to Avoid Stress
Commonest cause of stress at work is dissatisfaction with job and the commonest cause at home is marital disharmony. Therefore choose your career as well as mate with utmost care. Encourage, develop and strengthen areas of agreement at home.
Learn to enjoy your work by learning everything about your work and doing it to the best of your ability. Have a measure of control over your work—it is important for your happiness. Success may bring jealousies at work and are frequent cause of stress. Modesty and courtesy prevent the circumstances of hostility.
How to Utilize Stress to Your Advantage
• The road to reducing stress in our lives is 'EFFICIENCY'
• Stress provides an opportunity to improve our performance.
• Learn to accomplish more with less effort by avoiding wastage of effort.
• Seize control of success by replacing fear with confidence commitment, dedication and concentration.
• Define what is best to do and do it.
• Take calculated risks.
• Repeat past behavior that produced top performance-the more you repeat this behavior, the more will it become second nature with you.
• "A strong will, a settled purpose and invincible determination can accomplish anything" (Thomas Fuller).
• Each one of us has the potential to become a top performer
• It is top performance which gives happiness and joy and keeps the ill-effects of stress away.
How to cope with stress
• Make a conscious effort to control stress. There should be a daily routine to shed stress.
• To this end listen to music, meditate, develop hobbies, exercise, go for a leisurely stroll, or a joy ride in a bus or car.
• If you cannot go out, indulge in a hobby, e. g. play your guitar, sitar or violin
• Caffeine in any form heightens the stress level. Coffee is the worst offender; others are tea and cola drinks. Restrict their consumption.
• Sometimes circumstances may be beyond your control, a crisis in the family for example, or stress may gradually build up over months. Small irritations, loss of temper and frayed nerves may add up over a period of time. It is then that stress becomes distress and exerts its ill-effects. You should then back off, relax and prevent the situation from overwhelming you. At this point of time forget everything and go on a quiet holiday for a couple of weeks. You will come back refreshed.
• Meditation: Relaxation through meditation is becoming increasingly popular both in India and abroad. It is practiced in many ways. The principles are: Use a simple mental device which may be a 'mantra', a simple word or a visual symbol to relax the mind. Concentrate on the mental device, to the exclusion of everything else. The body will start relaxing. This happens because the mental device blots out all distracting thoughts. The technique is best learnt in a meditation centers.
This article is republished in India Study Channel
Three ways to deal with stress are:
1. Avoid stress, if possible
2. Utilize stress to your advantage, if you can
3. Cope with stress to prevent disease
How to Avoid Stress
Commonest cause of stress at work is dissatisfaction with job and the commonest cause at home is marital disharmony. Therefore choose your career as well as mate with utmost care. Encourage, develop and strengthen areas of agreement at home.
Learn to enjoy your work by learning everything about your work and doing it to the best of your ability. Have a measure of control over your work—it is important for your happiness. Success may bring jealousies at work and are frequent cause of stress. Modesty and courtesy prevent the circumstances of hostility.
How to Utilize Stress to Your Advantage
• The road to reducing stress in our lives is 'EFFICIENCY'
• Stress provides an opportunity to improve our performance.
• Learn to accomplish more with less effort by avoiding wastage of effort.
• Seize control of success by replacing fear with confidence commitment, dedication and concentration.
• Define what is best to do and do it.
• Take calculated risks.
• Repeat past behavior that produced top performance-the more you repeat this behavior, the more will it become second nature with you.
• "A strong will, a settled purpose and invincible determination can accomplish anything" (Thomas Fuller).
• Each one of us has the potential to become a top performer
• It is top performance which gives happiness and joy and keeps the ill-effects of stress away.
How to cope with stress
• Make a conscious effort to control stress. There should be a daily routine to shed stress.
• To this end listen to music, meditate, develop hobbies, exercise, go for a leisurely stroll, or a joy ride in a bus or car.
• If you cannot go out, indulge in a hobby, e. g. play your guitar, sitar or violin
• Caffeine in any form heightens the stress level. Coffee is the worst offender; others are tea and cola drinks. Restrict their consumption.
• Sometimes circumstances may be beyond your control, a crisis in the family for example, or stress may gradually build up over months. Small irritations, loss of temper and frayed nerves may add up over a period of time. It is then that stress becomes distress and exerts its ill-effects. You should then back off, relax and prevent the situation from overwhelming you. At this point of time forget everything and go on a quiet holiday for a couple of weeks. You will come back refreshed.
• Meditation: Relaxation through meditation is becoming increasingly popular both in India and abroad. It is practiced in many ways. The principles are: Use a simple mental device which may be a 'mantra', a simple word or a visual symbol to relax the mind. Concentrate on the mental device, to the exclusion of everything else. The body will start relaxing. This happens because the mental device blots out all distracting thoughts. The technique is best learnt in a meditation centers.
This article is republished in India Study Channel
Subscribe to:
Posts (Atom)