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Season's greetings Seasons greetings to all my readers.  The winter solstice is past and we can now look forward to longer days and shorter nights, while we enjoy a really white Christmas in many parts of the world. We...

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The battle of the bulge All of us make fun of fat people.  But, have you ever paused to think about how your derision affects the individuals self esteem? They may seem to laugh off your jokes, but deep down they are mortified;...

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Playing Poker for fun! Poker is fun.  It need not be a gamblers game. It can be a game that you play with your family members on holidays and weekends. While there are many forms of Poker, the simplest form is the five card...

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Are we rational to refuse belief in mantra and tantra? "The power of mantra or tantra?  I don't believe in that!" --that is the protest that is commonly heard among the so called rational intellectuals.  What is the rationality behind the disbelief?  Well,...

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The ifs and buts of allopathy Medicine and practice of medicine today, is standardized around allopathic (Western) medicine. All other systems are called "Alternate therapies".  Allopathy has become some kind of standard (like the...

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The battle of the bulge

Category : Communication, General, Information highway, Medical content, News and society, Self help

All of us make fun of fat people.  But, have you ever paused to think about how your derision affects the individuals self esteem? They may seem to laugh off your jokes, but deep down they are mortified; pained and depressed!  They are the people who have lost the battle of the bulge. Remember it is not nice to hit a person who is down.

Why does anyone lose the battle of the bulge?  The problem could be physiological or it could be psychological. A person suffering from hypothyroidism, anemia or one of the countless diseases that cause weight gain could become a helpless loser.  Depression could make the person binge eat and put on weight. A small percentage of  fat people  eat more calories than they burn and consequently end up flabby, fat and unhealthy.

While medical conditions causing weight gain will have to be treated with medicines, psychological conditions must be treated by psychiatrist. However, derision can catapult the person in the first category into the second one and the distinctions between categories can vanish.  The third category of people —namely the non exercisers–can certainly help themselves. They need not be fat if they do not want to join the battle of the bulge! Derision may even help them decide!

However, no one needs to lose the battle of the bulge. Even those who have gained weight due to medical causes can help themselves.  Exercise can restore muscle tone and reduce the flabiness of the body.  Hypothyroid patients will find that mild to moderate exercise under medical supervison improves metabolism and also circulation in the extremeties. It will help them reduce the numbness they experience in their hands and feet. Over a period of time all fat that is attributed to Hypothyroidism will also begin to melt and they can become healthy and even reasonably shapely.  Anaemic patients will find themselves losing weight as their anemia is cured with supplements. A healthy diet followed by reasonably vigourous exercise will help tone muscles and improve health. The same can be said to those who are binge eating due to psychiatric problems.  In fact mild to moderate exercise will also help them get over their psychological condition and eat normally.

So, if you come across fat people, do not poke fun. Find out what ails them and help them win the battle of the bulge.

The “ifs” and “buts” of allopathy

Category : Communication, Medical content, News and society

Medicine and practice of medicine today, is standardized around allopathic (Western) medicine. All other systems are called “Alternate therapies”.  Allopathy has become some kind of standard (like the dollar) against which we evaluate other schools of medicine.  So most alternate medicines are compared with allopathy and found wanting.  This also masks the fact that allopathy has as many “ifs” and “buts” as any other school of medicine.

Most alternate therapies are non intrusive and the treatments advocated are symptomatic.  Homeopaths use drugs that create the range of symptoms to address the problem–using a diamond to cut a diamond.  Accupressure and Accupuncture aver that diseases occur because the patient is experiencing energy blocks and removal of these blocks by exerting pressure on specific points will result in relief from the problems.  Allopaths are reluctant to accept the efficacy of these systems on the ground that they do not go to the root of the problem and identify the cause of the symptoms. Moreover, the treatment for every patient (even though the possible cause of the problem could be the same) is different.  Alternate therapies call this “constituitional treatment”. They believe that the disease may be the same but each person is constituitionally different and hence requires to be treated with constitutionally suitable medications.

Patients consulting the allopath are sent running from pillar to post, undergoing a number of tests in an effort to prove that the symptom is the result of a particular suspected condition. Doctor’s hope that some kind of picture will emerge from the different tests and this will help in the diagnosis of the problem.  The Doctor then, proceeds to make a diagnosis on the basis of the tests and prescribe from a standard set of medications–irrespective of their consitituition.  If a particular patient experiences more side effects than his fellowsufferer, it is just too bad.  An alternate drug may be prescribed –from the group of similar medications–or the patient may be asked to take the effect with the side effect as normal.

A recent illness of a relative had me doing the rounds of allopaths and hospitals. The tests concluded that the person was suffering from severe oesteoporosis.  The drug prescribed was Idrofos 150. This medication was to be taken once a month with injunctions that the patient should not lie down and should walk around for at least an hour after taking the medication etc.  Unfortunately, the allopath prescribing the drug did so without reference to the age of the patient, the possible side effects etc.  The fact that the patient experienced dizziness, hallucinations, undefined anxiety etc was dismissed as not related to the drug and a part of a psychological process of aging.  However, research into the possible side effects of the drug on the Internet clearly showed that the drug had the potentiality of producing just the side effects that my relative was experiencing. When we returned to the allopath with the evidence of the research, he refused to discuss further on the ground that no patients had experienced similar side effects in his practice.  He referred us to a psychiatrist.

Our visit to the psychiatrist was equally disheartening. She refused to consider the possibilty that the hallucinations were drug induced.  She refused to even look into the possibilities. Strangely, the psychiatrist spoke to me and not to the patient and preferred to arrive at her conclusions from her discussion with me.  Then she drew a page towards herself and began prescribing a tranquillizer, a sedative and some vitamins. When I queried about side effects of the drugs, she dismissed my question with an airy “All medications have side effects. Why worry about them?”  I was not satisfied.  I thought side effects of drugs required some amount of worrying over. In fact, I felt the Doctor should worry about it.  I had been worried enough by the side effects of the drugs already consumed.

Needless to say, I decided that “alternate therapies” were less intrusive and proceeded to get my relative treated with one of the several branches of Indian medicine, that is similar to accupressure, called Varmam.  She is gradually coming out of the woods and the side effects of the medication consumed also seems to be reducing with the passage of time.

So, do you agree there are “ifs” and “buts” in allopathy? Do you agree that the ifs and buts need to be recognized before all alternate therapies  are dismissed as unproven science.  The standard of reference is not a perfect standard! It has its own grey areas.

Laser Hair removal

Category : Communication, Medical content

When cutting, waxing, and shaving is no longer desirable or feasible, some patients seek laser hair removal.  Most people have hair covering their bodies that is lightly colored and fine and therefore, not directly visible to the eyes of others.  However, some experience darker and coarser hair in areas that might make them self-conscious, particularly in the summer months when shorts and swimsuits are worn.  This technique of hair removal is quick, effective, and nearly painless.

Electrolysis uses a fine probe and electrical impulse to cauterize the blood vessels causing hair to release permanently from the follicle.  Though electrolysis has a longer history of practice, lasers are commonly used now and have been well received by patients and physicians.  Laser treatment has a much shorter procedure either permanently preventing or greatly hindering hair re-growth.  Patients may immediately resume activities.  Laser hair removal is a widely popular procedure with nearly a million people having the treatment in the United States every year.  Patients should have realistic goals and carefully select a physician while informing themselves of the procedure and potential risks.

Ideal candidates for laser hair removal may be those who seek to improve their appearance or smoothness of the skin, or simply wish to save themselves time by reducing time involved in methods such as shaving.  Once the initial consultation is completed, the actual laser hair removal procedure may take only moments or up to an hour, depending on the size of the affected area.  A beam of highly concentrated light produced by a laser is emitted, passing through the skin, and is absorbed by hair follicle pigments.  Different colors of light are produced by different types of lasers, and this is relevant to the effect on follicles.  The pigment is vaporized, disabling many follicles at once, by the duration of the laser light pulses to the area.

Patients generally require multiple treatments to achieve ideal results.  Though some patients may be satisfied after only one treatment, the typical regimen likely includes up to four treatments, up to eight weeks apart.  Because hair growth cycles are typically about a year, patients should wait about six months to assess results.  If the procedure is performed with qualified physician and adequate consultation and care, any pain during the procedure should only consist of mild stinging.  Worst case scenario might include burns or pain that might require local anesthetic application.  Less serious effects such as redness and swelling will resolve in a few days.  Those with darker skin tones may not achieve optimum results as the surrounding skin will absorb the light rather than the follicle itself.  Affected areas will be sun sensitive and patients should avoid exposure for several days following laser hair removal.  Though the hair removal may be permanent, it could also be simply more sparse and of a lighter color or texture or consistency after the procedure.

Cosmetic Procedures: Fillers

Category : Medical content, website content

Plumping thin lips, enhancing contours, softening wrinkles, and improving appearance of recessed scars may be accomplished with injectable fillers.  Several different types of fillers may be used and include collagen, human fat, hyaluronic acid, hydroxylapatite, and PMMA.

Collagen, a natural protein, may produce results that last up to four months.  Certain types of collagen may require preliminary allergy testing in some patients.  Results of six months or more may be achieved by hyaluronic acid, a natural substance found in our bodies.  This may be used to fill in creases or plump lips.

To fill in deeper folds near the nose, frown lines, or to enhance fullness of the cheeks, hydroxylapatite may be used.  This is a compound found in human bones that is suspended in gel form and has mineral-like qualities.

Human fat harvesting and injection requires more extensive procedure because it uses liposuction to do the harvesting before the filler injection may be done.  This can fill in creases and contours to enhance fullness of the face.

FDA-approved PMMA is recommended to correct facial wrinkles such as smile lines.  PMMA is 20% polymethylacrylate and 80% purified collagen gel.

Though there is wide variance in results, patients may expect results to last up to a year in some instances.  Preserved fat injection results are more favorable if the fat is used at time of harvest.  Some filler may be FDA approved on a basis not specified to a particular application.

Patients may expect almost immediate improvement in appearance with some potential for bruising or swelling that will resolve.  There may be redness, sensitivity or itching briefly after the procedure.  Complications are rare and will vary depending on the type of filler used.  Rarely, filler may migrate to an unintended area producing temporary paralysis or there may be skin necrosis. There may be overcorrection. Milder symptoms from some fillers should resolve in just a few days, while the fat injections may produce symptoms that endure for a few weeks.   For the most part, fillers produce marked improvement in appearance and are safe and effective.  Choosing someone who is trained specifically in administering fillers and other types of rejuvenation is important.

Patients may experience anxiety about the procedure and are encouraged to have realistic expectations and ask questions.  Many variables affect results of fillers, and the results are not permanent though the substance is.  Issues such as continued aging and the way that the body absorbs the material will affect duration of results.  Without repeated treatment, issues such as thin lips or wrinkles and scars will reappear over time. With aging, fillers may shift or clump and surgical removal may be required to avoid unwanted changes in texture of soft tissue.  Consultation is required prior to treatment, but follow up visits take only moments.  Costs vary greatly, but many surgeons have financing available. Patients should inquire about their surgeon’s board certification and membership, years of experience, accreditation, the procedure and recovery period, and the way in which complications might be handled.

Balding? Hair restoration options

Category : Health and Exercise, Medical content, News and society

Men and women concerned about thinning hair may explore and choose the option of hair restoration by transplant.  Some may recall obsolete methods that looked unnatural, but may be comfortable with modern improvements that are basically undetectable to others.  A dermatologist is to be consulted in  the first place. The patient should provide him with his medical history and also details about expectations from the treatment.  The dermatologist must be informed of all medications the patient takes, including prescription, over the counter, and herbal supplements.  Blood tests may be suggested . This consultation will help establish candidacy for the procedure.

Certain medications may have to be stopped and antibiotics begun before the  commencement of the procedure. Patients will also be asked to avoid alcohol during the course of treatment.

Patients will be required to shampoo the night before the hair transplant  is performed in the dermatologist’s office or a hair transplant center.  The dermatologist will remove a strip of scalp from the back of the head that has good growth under local anesthesia. This is called a “prep strip”.  The prepped strip will  be divided into sections for suturing onto thinning or bald areas of the head.  Prepped slivers are carefully divided by technicians into grafts containing up to three hair follicles.  The procedure itself may last from 5 to 10 hours depending on the level of hair loss and transplant.  For optimum results, other restorative procedures such as scalp reduction or expansion may be combined with the transplant.  Often only one restoration treatment is required to produce satisfactory results.  If patients require additional restoration, it will be scheduled 6 to 12 months later.

Patients must take care to follow instructions for post-restoration recovery.  Instructions are normally given to prevent infection and minimize soreness that is inherent in the procedure.  Since it takes about five days for the hair to attach to the new area, patients must apply medication  carefully as directed.  Rubbing can cause the restored hair to fall out.  If scabs develop post restoration,  they must be left alone.  They generally heal in two weeks or less. Patients must wait a week to ten days to resume normal activities such as exercise to help prevent restored hair from falling out.

Though hair transplant is relatively safe and effective, it is not completely without risk of complication.  Follicle damage or other factors may produce poor or slow growth to the affected area.  Infection, scarring, or hyperpigmentation may occur.  Patients must keep their hair covered and protected from the sun for at least one month following the transplant to encourage ideal healing.

Meditation: Active or passive state?

Category : General, Health and Exercise, Medical content, News and society

Is Meditation an active or passive state? Anyone who observes the meditator would say “passive”. All the meditator seems to do is sit still, doing nothing.

There are many arguments in support of meditation being an active state!  They would point out that you can actually burn calories by doing meditation. Visit http://www.livestrong.com/thedailyplate/fitness/exercise/meditating/ and you will be told that meditation helps you burn 66 calories per hour for an average person–average being a person who weight 145 pounds.  http://caloriecount.about.com/calories-burned-light-meditating-a148 says that you can burn 70 calories  per hour if you weigh 150 pounds by doing light meditation.

You may then,  turn round to argue that even people who are sleeping burn calories. Of course, you do that in the assumption that sleep is not an active state! Well, it must again be pointed out that the active or passive state of sleep is itself in question.  However, studies show that you burn 60-72 calories an hour(per 150 lbs weight) during sleep. So sleep too is an active state for the purposes of our thesis.

Of course, we do not have to believe all this. We can look to scientific proof. Siebert, Gessner and Klasser who studied the energy consumed by the central nervous system when a person sits down to do some deep thinking reveals that the brain burns 230-270 calories an hour. {Energy supply of the central nervous system.PMID: 3516137 [PubMed - indexed for MEDLINE] Bibl Nutr Dieta. 1986;(38):1-26.].

While this is not much when compared to calorie loss during exercise, it is certainly a large amount for a small organ accounts for such a small part of the body weight! Also, it is a clear indication that “thinking” is activity that burns calories. It follows, that meditation which is a kind of focused and concentrated thinking, is an active physical state and not a passive one.

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1000-calorie diets

Category : Health and Exercise, Medical content, News and society

1000 calorie diets are recommended for those who want to lose weight.  This diet drastically reduces the calorie intake, but does not insist on any additional exercise or physical activity.  The logic is that a person who wants to reduce weight can continue doing the same level of activity with lower levels of calorie intake and the normal calorie burn up would take care of the excess weight over a period of time. 1000 calorie diets are short term diets that are to be undertaken for a period of ten days at a time under medical supervision. .

1000 calorie diets do not take into account the body weight, or calorie requirements of the individual.  A person who requires 1200 calories and a person who requires 2200 calories for his daily activity are treated on par. Both individuals are to consume only 1000 calories per day for the duration of the diet.

An average person loses around one pound for every three thousand five hundred calories cut down.  If you are cutting down the calories at the rate of 1200 calories a day, you will lose one pound in three days.

This diet also implies that you need to drastically change your eating habits for the duration of the diet. The diet recommends smaller meals that are eaten more frequently.  It cuts down on fats, sugar and lowers the consumption of carbohydrates.  Alcohol is to be avoided and diet soda and black coffee can be taken with limitations.

The calorie focus can rob the diet of interest.  If you are foodie, it is very easy to give up counting calories and abandoning the diet in frustration.  If you are an active person, you will find that the low calorie diet is depriving you energy.

Moreover, after the diet is complete, it is difficult to maintain the calorie levels at the 1000 calories.   The tendency is to revert back to the original levels. This will bring the weight back to the original level.

While there are many disadvantages of a low calorie diet, it is an effective way of kick starting a long term diet plan.

Acne? You are not alone!

Category : Communication, Medical content

Acne, a skin condition characterized by blackheads, whiteheads, and inflamed pustules, contemptuously called “zits” is a condition that affects many people.  Those who experience it often suffer from poor self-esteem due to self-image or the ridicule suffered at the hands of others.  Acne occurs when the porous skin surface becomes clogged.  While oil glands normally keep skin lubricated and help remove old skin cells, pores can become blocked by excess oil production.  Blockages, also called plugs or comedones, can result from accumulating dirt, debris, or bacteria.

Acne can appear virtually anywhere on the body and vary by degree, but it certainly does not discriminate by age, gender, or ethnic group.  The color of the top of the plug may be light in whiteheads, dark in blackheads, or inflamed cystic acne.  There appears to be a genetic predisposition with acne, but it can also be triggered by factors such as stress and hormone levels, reactions to medications, elements in cosmetic or grooming products, or sweating in humidity.  Some perpetuated myths about causes, such as chocolate for example, do not have scientific basis.

Many over the counter treatments are available, along with good advice for self-care.  Common non-prescription treatments might include celebrity endorsed regimens, and the simple act of keeping the area clean and dry while avoiding oily products or irritating the area further by digging at the skin.  Oily cosmetic or hygienic products are to be avoided, as are stimulation of the areas by handling too much or wearing cosmetics to bed at night.

Some acne patients seek the help of a dermatologist when all else fails. Prescription creams or antibiotics may be administered, though care should be taken with pregnant or sexually active adolescents must avoid some products.  Chemical peels or other cosmetic procedure may be used to remove scars or cysts to restore appearance of skin.   Natural sunlight, in moderation only, may help clear and dry affected areas.

After adolescence, acne may clear, but can last into midlife.  Acne patients may suffer periodic flare ups.  Scarring will likely occur if acne is severe and untreated.  Skin discoloration may occur in some.  Medications may cause undesirable side effects such as dryness, and scarring may cause some patients depression.   If after approximately three months, acne is severe, fails to resolve despite over the counter regimens, is leaving scars or damaging self-esteem, patients should contact a dermatologist for care.

If you have sciatica: check where you keep you wallet

Category : Communication, Medical content, News and society

What has sciatica got to do with your wallet? Well studies have shown that those who keep a stuffed wallet in their back pocket often suffer from sciatica. The possibility was first reported in an article in the “New England Journal of Medicine” in 1966.

This particular report was about a lawyer. The lawyer who was gradually accumulating charge cards in his wallet began to complain of pains in his left leg. These pains went away when he removed his wallet and returned when he stuffed it back into his pocket.  The patient’s condition was described as “credit-carditis”. Another person is said to have developed this condition from stuffing handkerchiefs in his pocket during a particularly bad run of hay fever. Another reported similar pains from stuffing his back pocket with golf balls.

So, credit cards are not the only reason why people got sciatica.  Truck drivers, sedentary workers, call center operators and others who stuff their wallets with visiting cards or sit with their chairs pressing into their piriformis muscle, too can suffer from sciatica.

The onset of the condition is very gradual and often unnoticed.  The piriformis muscle is connected with the sciatica nerve and this disorder occurs when it is irritated by the piriformis muscle. The person experiences pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh.

The diagnosis of this condition is largely clinical and one of exclusion. During physical examination the doctor will stretch the irritated piriformis and try to provoke a sciatic compression. This, rules out the possibility of herniated nucleus propulsus (HNP), facet arthropathy, spinal stenosis and lumbar muscle strain and all the high sounding medical conditions.  When all this has been excluded the doctor performs a simple operation called walletectomy–where he asks you to remove your wallet and empty it for his efforts.  Of course, he prevents you from putting it back in your back pocket with the visiting cards and credit cards.  If it is not your wallet but your seat that is causing you the problem, I am sure he will say “Now move it man!”

What I have learnt about vanishing fingerprints!

Category : Medical content, News and society

Having written the previous blog post on vanishing fingerprints with some glee, I got down to thinking seriously whether it is really possible for a person to lose their fingerprints.  Curiously, I came across an article which said that a man had been retained for hours at an airport in US because the officers could not detect his fingerprints.

After a quick search for an explanation of why his fingerprints went missing, I  found the answer.  It appears that this individual travelling from Singapore had been taking a cancer drug Capecitabine (Xeloda) for years and this had caused a hand foot syndrome that resulted in the erasure of his fingerprints. A typical outcome of handfoot syndrome is flaking, peeling and cracking of the skin in the hands and foot.

My search also led me to another finding about fingerprints that was immensely interesting. It seems children’s fingerprints are not as detectable as that of adults! The finding was that children’s fingerprints have more volatile chemicals, such as free fatty acids, while adult fingerprints display longer lasting compounds.

Further investigation also revealed that there were several instances when workers who did not wear protective gloves on their hands during physical labor often lost their fingerprints.

However, I could not find a single instance wher diabetes was the cause of vanishing fingerprints. Perhaps our medical friends can share the knowledge with us if that is true.

The question that remains now–What will the Government Department do now? Do they device another kind of biometric system for these workers?  If these workers are diabetic, they are likely to have problems with their eyes too! IRIS scan may also be ruled out?

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