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CORONA AND ELDERLY


In 2019, a new virus hit the world scene and is spreading rapidly, a novel Corona virus responsible for the respiratory disease COVID-19.

And in 2020, the World Health Organization (WHO) trusted Source declared the global outbreak of COVID-19a “public health emergency of international concern’’

Elderly people are at a higher risk of COVID-19 infection due to their decreased immunity and body reserves, as well as multiple associated comorbidities like diabetes, hypertension, chronic kidney disease and chronic obstructive pulmonary disease. Also, course of disease tends to be more severe in case of elderly patients resulting in higher mortality.

WHAT IS CORONA VIRUS ?
Corona virus disease 2019 (COVID-19) is defined as illness caused by a novel corona virus now called SEVERE ACUTE RESPIRATORY SYNDROME Corona virus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. They are a family of viruses that circulate in both humans and animals and can cause everything from the common cold to more serious respiratory illnesses.

RISK FACTORS IN ELDERLY PATIENTS

  1. People 65 yrs and older
  2. People who live in a nursing home or long-term care facility
  3. People with chronic lung disease or moderate to severe asthma
  4. People who have serious heart conditions
  5. People who are immunocompromised -on cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  6. People with severe obesity (body mass index [BMI] of 40 or higher)
  7. People with diabetes
  8. People with chronic kidney disease undergoing dialysis, Chronic liver disease

 

MODE OF TRANSMISSION

  1. Mainly spreads through droplets of saliva or discharge from the nose when an infected person coughs or sneezes
  2. Close contact with infected person in poorly ventilated rooms
  3. Touching or shaking contaminated hands
  4. Touching an object or surface with virus on it and then touching mouth, noseor eyes before washing hands

SYMPTOMS AND SIGNS
Symptoms may appear 2-14 days after exposure to the virus.

  1. Mild flu like symptoms-Dry cough, Fever, Sore throat, runny nose, fatigue, Headache, nausea, diarrhoea, loss of taste and smell,repeated chills with shaking, severe body pains
  2. Confusion, drowsiness, disorientation, excess sleepiness
  3. Moderate to severe symptoms- Shortness of breath, Pneumonia, Happy or silent hypoxia
  4. Severe Acute Respiratory Distress syndrome (SARS), Sepsis, Multi organ failure, death.

WARNING SIGNS

  1. Trouble breathing
  2. Persistent pain or pressure in the chest
  3. New confusion
  4. Inability to wake or stay awake
  5. Bluish lips or face

INVESTIGATIONS
Recommended tests include RT PCR analysis of Naso pharyngeal or throat swabs

WHAT TO DO IN A CONFIRMED COVID 19 ELDERLY PATIENT

  1. Wear mask, practice hand hygiene and take paracetamol for fever (avoid Ibuprofen).
  2. Take your regular medications
  3. Pay attention for potential COVID-19 symptoms like fever, cough, and shortness of breath or warning signs mentioned above. If any immediately seek medical care

Health Advisory for Elderly Population of India during COVID19

DO’s

  1. Stay at home. Avoid meeting visitors at home. If meeting is essential, maintain a distance of one meter.
  2. Wash your hands and face at regular intervals with soap and water.
  3. Sneeze and cough either into your elbow or into tissue paper / handkerchief . After coughing or sneezing dispose of the tissue paper/ wash your handkerchief.
  4. Ensure proper nutrition through home cooked fresh hot meals, hydrate frequently and take fresh juices to boost immunity.
  5. Exercise and meditate.
  6. Take your daily prescribed medicines regularly.
  7. Talk to your family members (not staying with you), relatives, friends via call or video conferencing, take help from family members if needed
  8. Postpone your elective surgeries (if any) like cataract surgery or total knee replacement
  9. Clean the frequently touched surfaces with disinfectant regularly.
  10. Monitor your health. If you develop fever, cough and/or breathing difficulty immediately contact nearest health care facility and follow the medical advice

DON’Ts

  1. Do not cough or sneeze into your bare hands or without covering your face.
  2. Don’t go near your contacts if you are suffering from fever and cough.
  3. Don’t touch your eyes, face, nose and tongue.
  4. Don’t go near affected/ sick people .
  5. Don’t self-medicate.
  6. Don’t shake hands or hug your friends and near ones.
  7. Do not go to hospital for routine checkup or follow up.
    As far as possible make tele-consultation with your healthcare provider.
  8. Don’t go to crowded places like parks, markets and religious places.
  9. Don’t go out unless it is absolutely essential.

What others can do to support older adults?
Older people can be helped to feel more positive if they engage with the world and stay active. Don’t lock them up and try to protect them. Make sure they are not immobile for long periods of time, watching television for long periods or remaining bed bound.

  1. Identify an emergency contact and keep the number on speed dial of the phone and also visibly displayed at home.
  2. Identify a caregiver in family or any community volunteer or police to help elderly by providing them essential supplies and keep a watch on general wellbeing of the elderly esp. who are staying alone. Also determine who can care for them if their caregiver gets sick.
  3. Provide psychosocial support.

 

Dr.M.Rose Raichel, MBBS, DNB(INT.MED),F.Diab
Consultant Physician and Diabetologist
Mehta Hospital Global campus, Velappanchavadi

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HAIR FALL

Hair fall is a common condition seen among both men and women. It is common to lose about 50-100 hairs per day. Increased hair loss, thinning and bald patches are a cause of concern and need an expert opinion for further management. Androgenic alopecia , is a common hereditary problem leading to severe psychological stress affecting ones confidence and self esteem.

CAUSES OF HAIRFALL

Angrogenic alopecia

Androgen excess in females

Alopecia areata

Cicatrical alopecia

Telogen effluvium

Post child birth

Thyroid disorder, anemia

Stress

Certain medications

Weight loss

Nutritional deficiency

 

MANAGEMENT OF HAIR FALL

Meeting an expert helps to identify the problem as well as start timely treatment. Thinning of hair and hairfall can be managed effectively by one of the following methods

MEDICAL MANAGEMENT

This includes certain topical medications and if required oral medicines for managing the hairfall. Early stages of hairfall can be effectively managed by this method

PROCEDURES

Dermaroller and prp can be used as an adjunct with medical management to improve the hairloss and thinning

HAIR TRANSPLANT

In those with baldness or severe grade, hair transplantation can be done . this involves transplanting hair from the donor site to the required area.

 

Article by
Dr Bharathi MS (Gen Surg),M.Ch (Plastic and Reconstructive Surgery)
Consultant, Plastic and Cosmetic Surgeon
Dr Mehta’s Hospitals, Chetpet

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BREAST FAT FILL

WHAT ARE THE TYPES OF BREAST AUGMENTATION?

Breast augmentation or enlargement can be done by implants or using ones own fat. Though most of us familiar with implants, breast fat fill is a newer procedure which is slowly  gaining popularity.

WHAT IS BREAST FAT FILL?

Breast fat fill is a procedure in which the patient is aspirated from one area(tummy, thighs, arms) and is used to augment or enlarge their breasts.

ARE YOU AN IDEAL CANDIDATE FOR BREAST FAT FILL?

In general women who have small breasts, who have lost volume post lactation, weight loss can opt for breast fat fill.

You are an ideal candidate

If you have small volume breasts with minimal or no sagging

Good physical and mental health

Ideal body weight

Realistic expectations

PROCEDURE DETAILS:

Breast fat fill is done as a day care procedure under general anesthesia. Pre operative markings and the areas from which fat is going to be aspirated is decided. Liposuction of the donor areas is done (tummy, thighs, back,arms)and the aspirated fat is injected into the breasts through a minimal incison(5mm) in the armpit/axilla. Post operatively a compression garment to the area of liposuction and support bra is advised for a period of 6-8 weeks. Strenuous activities  to be avoided for a period of two months.

 

DIFFERENCE IN RESULTS COMPARED TO BREAST IMPLANT.

Breast fat fill has a few advantages over breast implant, such as using ones own fat,removing fat from undesired area to augment a desired area. There are no scars over the breasts, only small scars in the armpit .however one has to remember that upto 20-30% of the injected fat may get absorbed and the patient may need another sitting to get the optimal results.

 

Article by
Dr Bharathi MS (Gen Surg),M.Ch (Plastic and Reconstructive Surgery)
Consultant, Plastic and Cosmetic Surgeon
Dr Mehta’s Hospitals, Chetpet

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COVID-19 and Cardiovascular Disease

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARSCoV-2). As of May 7th2020, infected patients were present in 167 countries/regions around the world and there were more than 3,85,000 cases worldwide with nearly 2,68,000 fatalities. COVID-19 interacts with cardiovascular system on multiple levels;

First, those with COVID-19 and pre-existing cardiovascular disease have an increased risk of severe disease and death.

Second, COVID-19 infection can cause acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism.

Third, therapies for COVID-19 may have serious adverse cardiovascular side effects.

Fourth, the response to COVID-19 can compromise the treatment of patients with cardiovascular conditions.

Finally, the provision of cardiovascular care may place health care workers at a high risk of contracting the virus

CLINICAL PRESENTATION:

SARSCoV-2 is spread predominantly via respiratory droplets, but also can be aerosolized or detected in the stool. Transmission may occur from both symptomatic and asymptomatic patients, with secondary infection rates ranging 0.5-5%. The median incubation time is 4-5 days and 97.5% will experience symptoms within 11.5 days of exposure. Reports from China demonstrate that a significant majority of patients (81%) had mild symptoms (no pneumonia or mild pneumonia) from COVID-19.

Among those with more significant symptoms, 14% experienced severe symptoms (dyspnea, respiratory rate ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within 24 to 48 hours) and 5% were critical (respiratory failure, septic shock, and/or multiple organ dysfunction or failure).

COVID-19 IN PATIENTS WITH PRE EXISTING CARDIOVASCULAR DISEASE (CVD): 

A meta-analysis of 6 studies inclusive of 1,527 patients with COVID-19 reported the prevalence of hypertension, cardiac and cerebrovascular disease, and diabetes to be 17.1%, 16.4%, and 9.7%, respectively. . Patients who required ICU admission were more likely to have these comorbidities than were non-ICU patients. Age is the strongest risk factor for CVD and the effect of aging on immune function may be equally important for COVID-19 susceptibility and severity. Patients with hypertension and CVD have higher expression of ACE2 enhancing susceptibility to SARS-CoV-2, although the data are conflicting.

CARDIOVASCULAR SEQUELAE ASSOCIATED WITH COVID-19.

COVID -19 Infections can cause MYOCARDIAL INJURY, MYOCARDITIS AND ACUTE CORONARY SYNDROMES. Myocardial injury, as defined by an increased troponin level, can occur due to myocardial ischemia or nonischemic myocardial processes including myocarditis. The profound inflammatory response, hemodynamic changes and Hypoxia associated with severe disease may confer risk for atherosclerotic plaque rupture in susceptible patients Cardiac arrhythmias are another common CV manifestation described in patients with COVID-19 infection. High prevalence of arrhythmia might be, in part, attributable to metabolic disarray, hypoxia, or neurohormonal or inflammatory stress in the setting of viral infection in patients with or without prior CVD. Heart failure, cardiogenic or mixed shock, ARDS /acute pulmonary edema, venous thromboembolic diseases are also reported with COVID-19 infection.

DRUG THERAPY AND COVID-19: INTERACTIONS AND CARDIOVASCULAR IMPLICATIONS

Although currently there are no specific effective therapies for COVID-19, various pharmacologic agents are under active investigation. As these drugs are being studied, it is important to review the potential CV side effects and interactions with other CV medications. Chloroquine and the closely related hydroxychloroquine have the potential for intermediate to-delayed myocardial toxicity, risk of torsade des pointes in patients with electrolyte abnormalities or with concomitant use of QT-interval– prolonging agents. Short-term exposure to these agents, as would be expected in treatment of COVID- 19, confers lower risk of these dose dependent side effects. Remdesivir is an investigational drug, now being studied in patients with COVID-19. Although extensive CV toxicities and medication interactions have yet to be reported, it may cause profound hypotension and cardiac arrest. Patients with severe COVID-19 may pose challenges in administering routine CV medications, ranging from antiplatelet therapy to beta-blockers, thus putting patients with ischemic heart disease or heart failure at risk of further deterioration of their clinicalcondition.

The COVID-19 pandemic has affected hundreds of thousands of patients and poses a major health threat on an international scale. I would strongly urge all cardiac patients to follow basic preventive measures such as social distancing, hand washing and prudent use of masks to prevent contracting the disease and avoiding any adverse outcome. 

DR.MIDHUN KUMAR, MD (GEN.MEDICINE), DM (CARDIO), DNB (CARDIO)

CONSULTANT CARDIOLOGIST

DR. MEHTA’S HOSPITALS

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BREAST LIFT

 

What is breast lift or Mastopexy?

Breast lift is a procedure in which saggy breasts are lifted, with or without adding volume to their ideal position by removing the excess skin and relieveing the physical and emotional distress one faces.

What are the symptoms?

Most often women complain of saggy breasts which appear flat deflated and shrivelled. The shape and sometimes even the volume will be lost giving them an aged look. The nipples may be pointed downwards and the aerola may be
enlarged. Most often finding the right innerwear and wearing fitting clothes would be difficult. Some suffer from emotional distress ranging from from low self esteem to depression sometimes affecting their career or even marital
life.

Are you an ideal candidate for breastlift or Mastopexy? 

  • If you have saggy aethetically unpleasing breasts?
  • You are doing this procedure for your self to make you happy
  • Have realistic expectations
  • In sound physical and mental health

Procedure details

It is usually done under general anaesthesia.. procedure takes about 2-3 hours and overnight stay st the hospital maybe required. After 48 hours the plasters will be removed and a supporting brassiere will be advised. Sutures
will be removed after a weeks time. Follow up once a week followed by once in two weeks for a period of 6 weeks maybe required. Patient should refrain from strenuous activities for a period of 6-8 weeks.

 


Dr Bharathi MS (Gen Surg),M.Ch (Plastic and Reconstructive Surgery)
Consultant, Plastic and Cosmetic Surgeon
Dr Mehta’s Hospitals, Chetpet

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IMPORTANCE OF COLONOSCOPY

A colonoscopy is an exam of the lower part of the gastrointestinal tract, which is called the colon or large intestine (bowel). Colonoscopy is a safe procedure that provides information other tests may not be able to give. Patients who require colonoscopy often have questions and concerns about the procedure.

Colonoscopy is performed by inserting a device called a colonoscope into the anus and advancing through the entire colon. The procedure generally takes between 20 minutes and one hour.

REASONS FOR COLONOSCOPY

The most common reasons for colonoscopy are:

  • To screen for colon polyps (growths of tissue in the colon) or colon cancer
  • Rectal bleeding
  • A change in bowel habits, like persistent diarrhea
  • Iron deficiency anemia (a decrease in blood count due to loss of iron)
  • A family history of colon cancer
  • A personal history of colon polyps or colon cancer
  • Chronic, unexplained abdominal or rectal pain
  • An abnormal x-ray exam, like a barium enema or CT scan

COLONOSCOPY PREPARATION

Before colonoscopy, your colon must be completely cleaned out so that the doctor can see any abnormal areas. This is vitally important to increase the chances that your doctor will identify abnormalities in your colon. If your colon is not completely cleaned out, the chances your doctor will miss abnormalities increases. Your doctor’s office will provide specific instructions about how you should prepare for your colonoscopy. Be sure to read these instructions as soon as you get them so you will know how to take the preparation and whether you need to make any changes to your medications or diet. If you have questions, call the doctor’s office in advance.

You will need to avoid solid food for at least one day before the test. You should also drink plenty of clear fluids on the day before the test. You can drink clear liquids (a liquid you can hold up to the light and see through) up to several hours before your procedure, including:

  • Water
  • Clear broth (beef, chicken, or vegetable)
  • Coffee or tea (without milk)
  • Ices
  • Gelatin such as Jell-O (avoid red gelatin)

Avoid drinking red liquids. Your doctor may also ask you to avoid high fiber foods including seeds and nuts for the week before the procedure.

To clean the colon, you will take a strong laxative and empty your bowels. You may be asked to take the entire preparation the night before the test, or you may be asked to take it in two doses, with the second dose taken four to six hours prior to the colonoscopy. Taking the preparation in two “split” doses may help get the colon even cleaner. This may require you to wake up early in the morning to complete the preparation. The instructions you are given will tell you how you should take the preparation.

A commonly used preparation is a 4-liter solution that is purchased at the pharmacy with a prescription. There are several low-volume (2- to 3-liter) preparations on the market as well. Some doctors prefer citrate of magnesia a 300 mL bottle that requires no mixing and is over-the-counter. Packets of powdered laxative are available that are mixed with a smaller volume of water. Sodium phosphate-based preparations are now usually avoided due to concerns over safety.

Refrigerating the solution can make it easier to drink, but do not put ice in the solution since it will melt and you will have to drink even more fluid. Drinking the solution through a straw, adding sugar-free powdered flavour packets (eg, Crystal Light), and taking half the preparation the night before and the other half later (four to six hours before your colonoscopy) may also make it easier to drink. Drinking this solution may be the most unpleasant part of the exam. Watery diarrhea is the desired result. This may occur shortly after drinking the solution or may be delayed for several hours. The end result should be diarrhea that looks like urine. If you become nauseated or vomit while drinking the solution, call your doctor or nurse for instructions. Tips that can help with nausea and vomiting include temporarily stopping drinking the solution, walking around, and resuming drinking at a slower pace.

Medicines — You can take most prescription and nonprescription medicines right up to the day of the colonoscopy. Your doctor should tell you what medicines to stop. You should also tell the doctor if you are allergic to any medicines.

Some medicines increase the risk of heavy bleeding if you have a polyp removed during the colonoscopy. Ask your doctor how and when to stop these medicines, including warfarin/ Coumadin, clopidogrel/Plavix, or any other anticoagulant (blood thinning) medicine. Do not stop these medications without first talking with your doctor.

Transportation home — Most patients are given a sedative (a medicine to help you relax) during the colonoscopy, so you will need someone to take you home after your test. Your doctor may prefer that an anesthesiologist administer the sedative and monitor you during the colonoscopy. Although you will be awake by the time you go home, the sedative/anesthetic medicines cause changes in reflexes and judgment that can interfere with your ability to make decisions, similar to the effect of alcohol. You will not be able to drive home or go back to work after the examination if you received sedation for the procedure. You should be able to return to work the next day.

WHAT TO EXPECT
Before the test, a doctor will review the procedure with you, including possible complications, and ask you to sign a consent form.

An IV line will be inserted in your hand or arm. Your blood pressure, heart rate, and breathing will be monitored during the test.

THE COLONOSCOPY PROCEDURE
You will be given fluid and medicines through the IV line. With sedation/analgesia provided during the colonoscopy, many people sleep during the test, while others are very relaxed, comfortable, and generally not aware. Your doctor may request an anesthesiologist give you an anesthetic agent, which is a stronger sedative and will put you to sleep while you are being closely monitored.

The colonoscope is a long black flexible tube, approximately the diameter of the index finger. The doctor will gently pump air or carbon dioxide and sterile water or saline through the scope into the colon to inflate it and allow the doctor to see the entire lining. You might feel bloating or gas cramps as the air opens the colon. Try not to be embarrassed about passing this gas (it is just air), and let your doctor know if you are uncomfortable. You may feel like you have to go to the bathroom, which is a normal feeling during the procedure.

During the procedure, the doctor might take a biopsy (small pieces of tissue) or remove polyps. Polyps are growths of tissue that can range in size from the tip of a pen to several inches. Most polyps are benign (not cancerous). However, some polyps can become cancerous if allowed to grow for a long time. Having a polyp removed does not hurt.

RECOVERY FROM COLONOSCOPY
After the colonoscopy, you will be observed in a recovery area, usually for about 30 to 60 minutes until the effects of the sedative medication wear off. The most common complaint after colonoscopy is a feeling of bloating and gas cramps. You should pass gas and not feel embarrassed doing this either during or after the procedure. This will relieve your feelings of bloating and cramping. You may also feel groggy from the sedation medications. You should not return to work, drive, or drink alcohol that day. Most people are able to eat normally after the test. Ask your doctor when it is safe to restart aspirin and other blood-thinning medications.

COLONOSCOPY COMPLICATIONS
Colonoscopy is a safe procedure, and complications are rare but can occur:

  • Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal and can be controlled.
  • The colonoscope can cause a tear or hole in the colon. This is a serious problem that sometimes requires surgery to repair, but it does not happen commonly.
  • It is possible to have side effects from the sedative medicines like nausea or vomiting.
  • Although colonoscopy is the best test to examine the colon, it is possible for even the most skilled doctors to miss or overlook an abnormal area in the colon.

You should call your doctor immediately if you have any of the following:

  • Severe abdominal pain (not just gas cramps)
  • A firm, bloated abdomen
  • Vomiting
  • Fever
  • Rectal bleeding (greater than a couple of tablespoons [30 mL])

AFTER COLONOSCOPY
Although many people worry about being uncomfortable during a colonoscopy, most people tolerate it very well and feel fine afterward. It is normal to feel tired afterward. Plan to take it easy and relax the rest of the day.

Your doctor can describe the results of the colonoscopy as soon as it is over. If s/he took biopsies or removed polyps, you should call for results within one to two weeks if your doctor has not already contacted you.

 

Article by

Dr Umalakshi Premnath
Consultant, Gastroenterologist
Dr Mehta’s Hospitals, Chetpet

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What is Jaundice?

What is jaundice?

Jaundice is a condition that causes your skin or the whites of your eyes to turn yellow. It happens when you have too much of a substance called ‘bilirubin’ in your blood.

What causes jaundice?

Jaundice is caused by problems with your liver, which is a big organ in the upper right side of your belly. It can also be caused with your gall bladder or pancreas.

Normally, the liver stores bile, a fluid that helps to breakdown fat. When you eat a mean that has fat in it, your gall bladder empties the bile into a tube called bile-duct. The bile-duct carries the bile into the small intestine to help digestion.

Problems with the liver, gall bladder and pancreas can be caused by:

  • Small stones that form inside the gall bladder, called gallstones , which can block the bile duct.
  • Infections
  • Heavy alcohol use
  • Damage from medicines, herbal supplements or illegal drugs.
  • Cancer

You can also get jaundice after surgery, if you have certain blood disorders, or if you have a condition called Gilbert’s syndrome.

Gilbert’s syndrome is a common, harmless condition that can run in families. People with this syndrome sometimes get jaundice when they are under stress., take certain medications or have an infection. Women with Gilbert’s syndrome might get jaundice around the time of their period.

Is there a test for jaundice?

Yes, your doctor will give you a blood test to measure the level of bilirubin in your blood. You doctor might also give you tests to see what’s causing the jaundice.

Will I need tests?

You doctor/ nurse will decide which tests you should have based on your age, other symptoms, and individual situation.

Tests doctors use to find the cause of jaundice might include:

  • Blood tests
  • An ultrasound-this test uses sound waves to pictures of the organs inside your belly.
  • An CT scan-this is a special kind of X ray.
  • An MRCP-this is a special kind of scan that lets your doctor look at your bile duct.
  • A biopsy- for this test, a doctor takes a small sample of tissue from your liver. Then another doctor will look at the sample under a microscope.

How is jaundice treated?

Treatments depend on what’s causing the jaundice. Your doctor or nurse might recommend that you:

  • Get plenty of rest- ask your doctor/nurse when it is pk to go back to work/school
  • Avoid alcohol
  • Avoid certain medicines- your doctor or nurse will talk with you about the medicines you take and tell you which ones to avoid.

If your jaundice was caused by gallstones, you might also need to take medicines or have surgery to remove your gall bladder.

Sometimes gallstones in the bile duct can be removed during an ERCP test. For an ERCP, the doctor inserts a flexible tube down your throat and takes X rays to see and remove gallstones.

If you have Gilbert syndrome, you will not need to do anything extra to treat your jaundice. Gilbert’s syndrome does not cause long term problems on its own.

 

Article by

Dr Umalakshi Premnath
Consultant, Gastroenterologist
Dr Mehta’s Hospitals, Chetpet

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ACID REFLUX AND GASTROESOPHAGEAL REFLUX

 

What is acid reflux?

Acid reflux is when the acid that is normally in your stomach backs up into the esophagus. The esophagus is the tube that carries food from your mouth to your stomach

When acid reflux causes bothersome symptoms or damage, doctors call it “gastroesophageal reflux disease” or “GERD.”

What are the symptoms of acid reflux?

The most common symptoms are:

  • Heartburn, which is a burning feeling in the chest
  • Regurgitation, which is when acid and undigested food flow back into your throat or mouth

Other symptoms might include:

  • Stomach or chest pain
  • Trouble swallowing
  • Having a raspy voice or a sore throat
  • Unexplained cough
  • Nausea or vomiting

Is there anything I can do on my own to feel better?

Yes. You might feel better if you:

  • Lose weight (if you are overweight)
  • Raise the head of your bed by 6 to 8 inches – You can do this by putting blocks of wood or rubber under 2 legs of the bed or a foam wedge under the mattress.
  • Avoid foods that make your symptoms worse – For some people these include coffee, chocolate, alcohol, peppermint, and fatty foods.
  • Stop smoking, if you smoke
  • Avoid late meals – Lying down with a full stomach can make reflux worse. Try to plan meals for at least 2 to 3 hours before bedtime.
  • Avoid tight clothing – Some people feel better if they wear comfortable clothing that does not squeeze the stomach area.

How is acid reflux treated?

There are a few main types of medicines that can help with the symptoms of acid reflux. The most common are antacids, histamine blockers, and proton pump inhibitors. All of these medicines work by reducing or blocking stomach acid. But they each do that in a different way.

  • For mild symptoms, antacids can help, but they work only for a short time.
  • Histamine blockers are stronger and last longer than antacids. You can buy antacids and most histamine blockers without a prescription.
  • For frequent and more severe symptoms, proton pump inhibitors are the most effective medicines. Some of these medicines are sold without a prescription. But there are other versions that your doctor can prescribe.

Sometimes, medicines cost less if you get them with a doctor’s prescription. Other times, non-prescription medicines cost less. If you are worried about cost, ask your pharmacist about ways to pay less for your medicines.

Should I see a doctor or nurse about my acid reflux?

Some people can manage their acid reflux on their own by changing their habits or taking non-prescription medicines. But you should see a doctor or nurse if:

  • Your symptoms are severe or last a long time
  • You cannot seem to control your symptoms
  • You have had symptoms for many years

You should also see a doctor or nurse right away if you:

  • Have trouble swallowing, or feel as though food gets “stuck” on the way down
  • Lose weight when you are not trying to
  • Have chest pain
  • Choke when you eat
  • Vomit blood or have bowel movements that are red, black, or look like tar

What if my child or teenager has acid reflux?

If your child or teenager has acid reflux, take him or her to see a doctor or nurse. Do not give your child medicines to treat acid reflux without talking to a doctor or nurse.
In children, acid reflux can be caused by a number of problems. It’s important to have a doctor or nurse check for these problems before trying any treatments.

 

Article by

Dr Umalakshi Premnath
Consultant, Gastroenterologist
Dr Mehta’s Hospitals, Chetpet

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GOOD NUTRITION DURING PREGNANCY

 

The Preganant Woman Needs More Calcium , Iron & Protein

Most pregnane woman can meet these increased nutritional needs by choosing a diet include a verity of healthy foods a simple way ensure you are a getting all the necessary nutrients is to eat different foods from each of the food group of everyday.

Each food group has something to offer your body.

For Examples:

  • Grains are a good source ofenergy.
  • Fruits and vegetables are packed with antioxidants, fiber, and water-soluble and fat-solublevitamins.
  • Meats, nuts, and legumes provide your body with protein, folate, andiron.
  • Dairy products are great source of calcium and vitaminD.

PROTEIN

Protein is critical for ensuring the proper growth of fetal tissue, including the brain. It also helps with breast and uterine tissue growth during pregnancy.Protein rich foods.

  • Lean beef andpork
  • Beans
  • Chicken
  • Salmon
  • Nuts
  • Peanutbutter
  • Cottagecheese

CALCIUM

Calcium helps build your baby’s bones and regulates your body’s use of fluids.Pregnant women need at least three servings of calcium per day.

  • Milk
  • Yogurt
  • Cheese
  • Cabbage
  • Tofu
  • Eggs
  • Pudding

FOLATE

Folate,alsoknownasfolicacid,playsanimportantpartinreducingtheriskof neural tube defects. These are major birth defects that affect the baby’s brain and spinalcord,

  • Liver
  • Nuts
  • Dried beans andlentils
  • Eggs
  • Nuts and peanutbutter
  • Dark green leafyvegetables

IRON

Ironworkswithsodium,potassium,andwatertoincreasebloodflow.Thishelps ensure that enough oxygen is supplied to both you and yourbaby.

  • Dark green, LeafyVegetables
  • Citrusfruits
  • Enriched breads orcereals
  • Lean beef andpoultry
  • Eggs
  • Diedfruit

Eat these

  • At least three servings of protein perday
  • Six or more servings of whole grains perday
  • Five or more servings of fruits and vegetables perday
  • Three or more servings of dairy products perday
  • Foods with essential fats and Prenatalvitamins

Avoid these

  • Alcohol and Excessivecaffeine
  • Raw meats and seafood and High-mercuryfish
  • Uncooked processed meats and Unpasteurizeddairy

 

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ARE EGGS GOOD OR BAD FOR YOU?

 

All of us are having different views on some information gathered on the internet about the nutritious value of eggs. Isn’t it?

Let me tell you the exact fact, Eggs are a very good source of high-quality protein and are rich in sources of DHA, selenium, vitamin D, B6, B12 and minerals such as zinc, iron, iodine, phosphorous and copper. While the yolk provides important vitamins, minerals, essential fats and protein, the white is almost exclusively protein and some trace minerals.

As a matter of fact, one whole egg has most of the essential nutrients that is required for our body’s daily metabolic process. It also contains most of the right vitamins and minerals which are needed for regular functioning of cells, memory and nervous system.

One large egg contains about 180 milligrams of cholesterol. It’s advised to cap dietary cholesterol at 300 milligrams daily. So it’s completely safe to have 1 whole egg per day for healthy people. Concern on cholesterol content has to be looked upon only for cholesterol sensitive people like cardiac patients, obese people etc.

Raises good cholesterol

Helps in raising good cholesterol, vision and brain function. Docosahexaenoic acid (DHA) element present in eggs helps in the maintenance of brain function, vision, and lower blood triglycerides.

Eggs when consumed in moderation can help you to increase the High-Density Lipoprotein (HDL) which is also known as good cholesterol. Higher levels of HDL lower down the risk of heart disease, stroke, and other health problems.

High in quality protein

A single large egg contains around seven grams of protein. Proteins are the building blocks of the human body as they formulate all sorts of tissues which serve as a structural and functional process. Since protein is essential for stronger bones, increasing muscle mass, help in weight loss etc. , consuming eggs daily helps in meeting enough protein requirement of the day.

Eggs contain all the essential amino acids which mean it has complete protein with high biological value so that it can get absorbed completely in our body. 

Rich in anti-oxidants

Eggs are high in vitamin A and two powerful antioxidants – lutein and zeaxanthin. Hence Cataracts, Blindness and macular degeneration can be reduced by consuming eggs daily.

Supplies Essential Minerals

Minerals like iron, zinc, and phosphorus are present in eggs in great amounts. Zinc maintains your immune system and turns food into energy. Iron helps in carrying oxygen to tissues. Eggs are also rich in iodine, which is required to make thyroid hormones, and selenium.

How to make sure Safe Consumption?

As eggs may get contaminated with Salmonella bacteria which could cause food poisoning, raw or semi-cooked eggs are not recommended for all. Since cooking eggs completely kills the bacteria, It is always safe to consume cooked eggs.

Foods made with raw or lightly cooked eggs are not recommended for young children, elderly people, pregnant women and people who are already unwell. Eg. Mayonnaise, pastries made out of raw egg creams, etc.

Completely-boiled eggs are also low in calories. To conclude, shorter and lesser-heat cooking methods cause less oxidation of cholesterol and help retain most of the nutrients in the eggs. Hence, poached and boiled (either hard or soft) eggs are the healthiest to eat. As these cooking methods also don’t add any unnecessary calories.

How to find out the spoilage?

Rotting of eggs with foul smell is the common form of spoilage and such eggs must be avoided. Or else may lead to dangerous food poisoning. Candling which is a technique which involves rotating egg in front of the candle light. This helps in identifying cracks, rots etc.

Is 1 whole egg per day is recommended for all?

No, nutrition requirement is always individualized. This recommendation is enough for a healthy sedentary worker with a balanced meal plan (my plate ) but the requirement will vary for person with special nutritive needs such as pregnant/lactating women, cardiac patients, critically ill/vulnerable patients, persons with hyperlipidemia, fatty liver, obese patients, players, athletes, person with special nutritive needs and gym go-er etc.

You should contact a certified Nutritionist/Dietitian for a tailor-made diet chart.

 

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