OCTOBER 2018
EDITORIAL Publishing Director & eDitor in chief V. Bhargava bhargavavicky@rocketmail.com Publisher, Printer & eDitor Ravi Pathak consultant eDitor Ratan Mani Lal contributing eDitors Dipna Kriplani, Ahmedabad Daya Kingston, Chennai Khusboo Singh, Bhubaneshwar Kriti Gupta, New Delhi eDitoral Desk Shweta Malviya, Manoj Singh, art Director Raj Bhagat Visualisers Ranjit Mongia, Prasoon Pal illustrators Nitesh Kushwaha, Rituraj Raman PrinciPal PhotograPher Nilendra Singh PhotograPhers Aditya Goswami (New Delhi) Nilanshu Khatri (New Delhi) Babar Ali (Mumbai) Ashok Krishnaswamy (Chennai) Prabhu (Pondicherry) Subhamoy S. Roy (Kolkata) Akhil Ranjan (Bhubneshwar) Aakash Jagtap (Pune) Anoop Taneja (Jalandhar) Bejoy Viswas (Kochi) Renjith M (Calicut) Gurmeet Singh Sidhu (Kota) Syed Shakeel Hussain (Hyderababad) Nitin Arora (Lucknow) Bindu (Tirupati) Sanjay Kapur (Nagpur) Utpal Barua (Guwahati/N.E.) Kishore Raj (Raipur/Chattisgarh) Zafar (Kolhapur) Ravi Shankar (Patna) Licensed images: Shutterstock/Canstock Printed & Published by Ravi Prakash Pathak for Pugmarks Media, from 63/9A, South Lokpur, Naini, Allahabad 211008 and Printed by him at Bhargava Press, 11/4, Bai ka Bagh, Allahabad 211003. Editor: Ravi Prakash Pathak IVF India does not take the responsibility for returning unsolicited publication material. All disputes are subject to the exclusive jurisdiction of competent courts and forums in Allahabad only. Opinions expressed in the articles are of the authors and do not necessarily reflect those of the editors or publishers. While the editors do their utmost to verify information published they do not accept responsibility for its absolute accuracy.
An iVf iNDiA special issue
But the real secret to lifelong good health is actually the opposite: Let your body take care of you. Deepak Chopra Eggs have been much maligned till recent research showed that they are not really bad for your health and infact have nutrients which are healthy. Everyone desires a perfect body. Till recently cosmetic surgery was the exclusive domain of women. Now men are more than willing to go under the knife to get that perfect look. In this issue we take a close look at 6-packs Ab etching. Diabetes affects about 5% of the Indian population. Here we explain the causes, complications, prevention and treatment options for this dreaded disease. In this issue we also explain in detail ‘Ovarian Cancer’ which is affecting more and more women. Depression affects about 2% of preschool and school-age children. Depression in children
does not have one specific cause but rather a number of biological, psychological, & environmental risk factors that are part of its development and can lead to suicide. Here we explain how parents can help prevent suicide in children. Infertility in India is reaching epidemic proportions. It is a financially and emotionally draining experience for the couple. It is unfortunate that it is yet to be covered by medical insurance. Our fitness section offers you the best tips to sculpt a body to die for. A special section ‘Fit @ 50’ offers tips for staying fit as you grow older. Team He & She looks forward to hearing from you to make ourselves better and more responsive to ‘your’ needs.
www.fitlife.fit editor@fitlife.fit Disclaimer: This information published in He & She is for educational purposes only and should not be used in any other manner. This information is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a qualified health care provider.
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Contents 18 HEALTH BENEFITS OF EGGS 20 FRUITASTIC SMOOTHIES 26 BEST EXCERCISES FOR JIGGLY ARMS 28 FOODS TO BOOST YOUR LIBIDO AND FERTILITY 33 6 PACK AB ETCHING! 36 WHAT’S MAKING YOU SCRATCH? 38 FIT @ 50 42 SUICIDE IN CHILDREN 44 DIABETES 50 PCOS & INFERTILITY 53 PCOS & HOMEOPATHY 55 OVARIAN CANCER 60 OBESITY & INFERTILITY 64 HEALTH ISSUES YOUR ‘MANHOOD’ IS INDICATING 66 OBSESSIVE COMPULSIVE DISORDER 69 HOW ALCOHOL AFFECTS YOUR BODY 70 SEXUAL PROBLEMS IN MEN 74 FITNESS FUNDAS FOR MEN 80 ACID REFLUX 82 PREIMPLANTATION GENETIC TESTING 84 FITNESS FUNDAS FOR WOMEN 90 CEREBROVASCULAR STROKE 96 PRESERVE YOUR FERTILITY FOR THE FUTURE 98 THE NORDIC DIET
Model: Rajan Dwivedi Photographer: Neelendra Singh Styling: Anwar
Cover: PRATEIK JAIN & SONY KAUR Location and models courtesy: GOLD’S GYM INDIA
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Singing in the shower can burn an extra 10-20 calories per song depending on the pitch & volume.
You burn about 200 calories in 30 minutes of active sex. You can burn upto 350 more calories per day if you fidget.
On an average, brushing your teeth for 3 mins will burn 10 calories.
Not sleeping for a night burns an extra 161 cals.
If you walk your dog for 30 mins you burn 100 calories HE & SHE
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OUR SPECIALISTS ON BOARD
The brain is more active at night than during the day. Scientists don't know yet why this is.
PROF. DR SUDHA PRASAD Prof. Dr Sudha Prasad is the Director, Professor in Obstetrics and Gynecology at Maulana Azad Medical College & Coordinator of IVF and reproductive Biology Centre at MAMC, New Delhi. She has to her credit of starting low cost IVF in the public sector, Govt. of Delhi.
DR. RUPIN SHAH
DR. PRASHANT NYATI
DR. SAGAR BHATTAD Dr Sagar Bhattad is the First DM (super-specialist) in the field of Pediatric Rheumatology and Immunology in India. Experienced in the management of children with arthritis, vasculitis, Primary immune deficiency, HIV/AIDS, Nephrotic Syndrome. He is a Consultant Paediatric Immunologist, ASTER CMI Hospital, Bangalore
Dr. Nyati is a Consultant Gynecological & Robotic OncoSurgeon at SL. Raheja Hospital, Mumbai. With more than 13 years of dedicated experience, his area of interest is Ovarian, Cervical, Endometrial and Vulvar Cancer treatment, Robotic Surgery for Cervical & Endometrial Cancers, Fertility Sparing Surgery and advanced Ovarian Cancer surgery.
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Dr. Shah has been associated with Lilavati Hospital for over 15 years & has been in clinical practice for almost 30 years. Dr. Shah is the first urologist from India to train abroad in andrological microsurgery & developed India's first penile prosthesis in 1996. He has received multiple awards and honours.
DR. SHANTI SWAROOP DHAR Dr. Shanti Swaroop Dhar is a Gastroenterologist in Panchsheel Park, Delhi and has an experience of 18 years in this field. He practices at Max Multi Speciality Centre - Panchsheel Park, Delhi and Max Hospital in Sushant Lok I, Gurgaon & is a member of Indian Society of Gastroenterology.
DR. FABIAN ALMEIDA
Dr. Fabian Almeida is a Consultant Psychiatrist at Fortis Hospital Kalyan with a rich experience of over 20 years in the field of Mental Health.
DR. SIMI SOOD
Dr. Simi Sood has brought IVF to the doorstep Mewar. Her bigger motivation was to make infertility treatment easily accessible to the rural population at an affordable cost. She dared to think beyond the obvious and till date, Neelkanth Fertility has brought smiles to thousands of infertile couples.
DR. PARAG TELANG Dr, Parag Telang is a Plastic & Reconstructive Surgeon at SL Raheja Hospital, Mumbai. He is skilled in wound care, tummy tuck, head and neck aesthetics, including minimal access facelift, ear reconstruction using autologous rib cartilage, postmastectomy breast reconstruction
DR. SHEFALI DINESH JAIN DR. DEEPAK GOENKA Dr. Deepak Goenka is Director, Dr. Shefali Dinesh Jain is a Infertility Specialist, Institute of Human Reproduction, Guwahati, he has Gynecologist and Obstetrician in Indore and has an experience had extensive training in Ultrasound, ART and Genetics at of 28 years in these fields. She different leading centres of the practices at Asian Institute of world. He has performed more Infertility Management, Indore. than 15000 IVF cycles and more than 3500 laparoscopy surgeries.
DR. MUKESH KUMAR Dr. Mukesh Kumar is a Neurologist and has an experience of 16 years. Dr. He practices at Max Hospitals in Gurgaon & Delhi. Dr Kumar specialises in: Parkinson's Disease Treatment, Botulinum Toxin,Myasthenia Gravis,Deep Brain Stimulation and Movement Disorder etc.
If your saliva cannot dissolve or mix with food, you will not be able to taste that food (try tasting something after drying off your tongue).
DR. PRANAY BHUSHAN Dr. Pranay Bhushan is a Postgraduate in orthopaedics, with specialty fellowships and trainings from Germany. He specialises in trauma, orthopaedics, joint reconstruction and replacement He likes to listen to music, singing, driving and social education.
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Tips, Tricks & Treats
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it releases oxYtocin A lot of the health benefits from cuddling are directly related to the oxytocin boost it gives you. Oxytocin is sometimes called the “love hormone” because it’s triggered by all the love stuff: kissing, cuddling, having sex. When you’re cuddled up with someone, your brain releases more oxytocin than it would when you’re, say, cleaning or working or doing anything else not love-related.
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Promotes bonDing The first health benefit of oxytocin that scientists isolated was that it’s released in order to promote bonding between women and their babies. But it turns out it’s not just great for mother/child bonding - it’s also excellent for connecting more strongly with a romantic partner or a good friend.
LET’S JUST CUDDLE I’m a cuddle monster. I’ve been a cuddle monster since I was very, very little. There’s just something about getting all snuggled up with someone that gets me, every time. I always thought it was because I’m a natural-born hedonist, but apparently there are some major health benefits to cuddling, too.
eases stress Cuddling eases stress by releasing oxytocin, which is like an all natural anti-anxiety medication. But it’s also a time that your body is relaxed and comfortable; a break from the hectic nature of most people’s daily lives. finally, we’re usually doing other relaxing things when we cuddle - watching TV on the couch, lying in bed - and taking time for breaks like that is great for stress levels, too.
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helPs You sleeP This one might seem like a “duh,” but cuddling helps you fall asleep. There’s the obvious - you’re comfy in bed, so falling asleep is the next natural thing - but then our old friend oxytocin also comes into play. One study found that oxytocin promoted sleep in the brains of mice. There was one caveat, however: it had to be under stress-free conditions. So maybe in order to get this benefit you should make sure not fight in bed? (i mean, that’s generally good life advice, anyway.)
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boosts Your immune sYstem in addition to oxytocin, cuddling also releases the “happy hormone” serotonin. Those two together work to boost your immune system. A study found that people who hugged more were less likely to contract a cold after being exposed to the cold virus and that those who did get sick had less severe symptoms.
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imProVes Your heart health Stress is really, really bad for your health. And guess what body part it’s super bad for you? You got it - your heart. A study found that a brief hug followed by holding hands while watching a 10-minute video was associated with lower blood pressure and heart rate, when compared with people who didn’t hug and hold hands. if that’s possible in 10 minutes, imagine what an entire afternoon of Netflix and actually chilling might do?
boosts Your sexual anD relationshiP satisfaction And, last but certainly not least, cuddling boosts your sexual and relationship satisfaction - especially if you have kids. A University of Toronto Mississauga published in the Archives of Sexual Behavior in 2014 found that cuddling more after sex was associated with higher sexual and relationship satisfaction, even three months after the study period. The study also found that effects were more pronounced for women than men and that couples with children reported even higher benefits than childless couples.
not getting enough sunlight Many people know that spending time outside gives you a boost of Vitamin D, which is a critical nutrient when it comes to your bone health. Vitamin D plays an important role in protecting your bones, both by helping your body absorb calcium and by supporting muscles needed to avoid falls.
being a couch Potato if you're too sedentary, your bones can take a hit, as exercise can strengthen bones in the same way that it can strengthen muscles. To build strong bones, you need weightbearing and muscle-strengthening exercise. Weight-bearing means 'on your feet' exercises, so walking, running, dancing, aerobics, are all examples. Muscle-strengthening means resistance exercises, such as light weights, using exercise bands, yoga and pilates.
Habits which hurt your bone Health Most of us don't spend too much time fretting about our bones. Not only can we not directly see them, but thinking about your bones seems like something you only have to deal with when you're older. However, you might not realize it, but there are a number of everyday habits that could hurt your bone health. Although you might not feel the repercussions now, you won't want to suffer the consequences later.
smoking That cigarette habit is doing more than just hurting your lungs. Several studies have linked smoking with an increased risk for osteoporosis and bone fractures. Smoking is linked to an increase in production of the stress hormone cortisol, which weakens bone and it impedes production of the hormone calcitonin, which helps build bone.
Drinking alcohol Drinking too much alcohol interferes with the balance of calcium in the body. it also affects the production of hormones, which have a protective effect on bone and of the vitamins we need to absorb calcium. Excessive alcohol consumption can also lead to more falls and related fractures.
Drinking soDa Most of us know that soda isn't exactly the healthiest of beverages, but in addition to its sugar content, it can also block absorption of important nutrients. The phosphate in the soda-pop binds with calcium so that your body doesn’t absorb it. Research is mixed - as there is no good evidence that a high phosphate intake affects bone metabolism or bone density, according to Harvard Health. However, carbonated beverages have long been associated with low bone density and fractures in adolescent girls, so it's best to go easy on the soda.
eating an imbalanceD Diet The foods that you eat can affect your bones. Getting enough calcium is essential to building strong, dense bones when you’re young and keeping them strong and healthy as you age. Not eating a wellbalanced diet that includes the recommended amount of calcium can have a negative effect on your bone development and remodeling. Too much salt in the diet can also be detrimental to bone.
If you love eating food so hot that your eyes run, your nose streams, and you're still feeling it several days later, there's good news for you: spicy foods have some health benefits you probably didn't know about. Evidence suggests humans have been adding spice to their food for many centuries. That love for the tingle in our lips has been passed down through generations, and for good reason. While it may seem contradictory that a type of foodstuff that gives us pain while eating it could also have health benefits, science is increasingly revealing that indulging in chili peppers and other eye-wateringly hot spices is a good thing for our hearts, our brains, and our lifespan in general.
SPICE IS ALWAYS NICE
They Make You Less Likely To Crave Salt Oddly enough, having a diet high in spice means you'll be more likely to keep your food low in sodium, which is good for your heart health. That's the conclusion of a study in 2017 by the American Heart Association. They Help Can Promote Longevity If you have a diet where you eat quite a lot of red chili peppers, you're also likely to enjoy a longer lifespan. Mostly, eating lots of peppers seemed to be protective against heart attacks and stroke. But capsaicin also possesses antimicrobial properties that may indirectly affect the host by altering the gut microbiota." They May Inhibit The Growth Of Gut Tumors One area where capsaicin has been the focus of a lot of attention is the gut. It turns out, according to a 2014 study from the University of California San Diego, that spicy food may have long-term benefits for our gut health. The study used capsaicin in the diets of mice, and found that it meant that the cells in the walls of the intestine became highly stimulated when they were exposed to capsaicin. And those cells fought off the development of tumors in the colon and rectum more successfully than in the guts of mice who hadn't had any spice. They Relax Your Blood Vessels One of the reasons that capsaicin may be so good for overall lifespans when ingested as part of a balanced diet is that it seems to be good for blood flow. It reduces blood pressure, because it makes blood vessels more "relaxed" by blocking genes that tend to make our blood vessels more contracted. They Also Fight Off Bad Cholesterol Scientists in 2012 found that capsaicin breaks down "bad" cholesterol in blood while leaving "good" cholesterol intact, which has a knockon effect on blood pressure levels and your overall health. They Can Help Sinus Pain Got a bad sinus inflammation? According to a study from 2011, a nasal spray including capsaicin might be one of the best ways to clear it up. This sounds absurd and possibly painful, but the results of the small study, which used a mix of placebo and capsaicin sprays on 44 people who had long histories of nasal problems not linked to allergies. It was one of the first chemical trials of the idea, and it worked; people felt relief within a minute when they used the capsaicin spray, and the effects lasted longer than an hour.
CHECKiNG WORK EMAiLS AfTER HOURS MAY DAMAGE YOUR MENTAL HEALTH & YOUR RELATiONSHiP Once you leave your job, is your work for the day done, or do you find yourself constantly checking and returning emails? Well, a new study just revealed that work emails could affect your mental health if you’re still expected to check them when you’re no longer on the clock. And, they’ll not only affect your health, but your partner’s health, as well. The findings were published recently in the Academy of Management Best Paper Proceedings. if you’re someone who feels obligated to still “work” outside of work, you’re not alone. in the study, 142 people who work full-time were surveyed, and their significant others were, too. They were asked about their jobs’ expectations regarding electronic communication during non-work hours. To see how it affected them, they were also asked about their health and relationship satisfaction. As you can imagine, those who said they feel obligated to check work emails outside of work had a lower sense of well-being and increased anxiety, and it also affected their relationships in negative ways. Employees’ partners who are also online for work during off hours reported the same feelings of a lowered sense of wellbeing and decreased relationship satisfaction. The study called this a “spillover effect.”
The very last person on your mind before you fall asleep is either the reason for your happiness or your pain
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THE WORLD’S LARGEST PUBLIC SAUNA: A Norwegian art project has installed the world’s largest public sauna on a remote beach on an island in the Arctic Circle. The sauna can hold over a hundred people so if you’re a person who enjoys the company of many others, this sauna would fit you perfectly!
THE SALT SAUNA: This salt sauna in Den Bosch, The Netherlands, has walls made of Himalayan salt. Apparently the salt in the sauna has a lot of health benefits including regulation of blood sugar, and let’s be honest, the sauna is breathtakingly beautiful!
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Health Benefits Of Saunas You Probably Didn’t Know About There's nothing more relaxing than hitting up the closest spa and letting all your worries melt away in the sauna. The health benefits of saunas, the heated, wood-lined room common in Scandinavian cultures, have been touted for thousands of years. THEY CAN LOWER YOUR BLOOD PRESSURE Half an hour in a sauna, a research by Mayo Clinic showed, lowered both systolic and diastolic blood pressure. These two numbers are what give your normal blood pressure reading: 'systolic' is the pressure on your blood vessels during a heartbeat, and 'diastolic' is the pressure between beats. THEY MAY MAKE YOUR BLOOD VESSELS MORE RESPONSIVE Saunas, it turned out, make your blood vessels really responsive to pressure, and also heighten your heart rate; it was pretty common, according to the scientists, to see peoples' heart rates increase as if they were doing some moderately intensive exercise THEY RELAX YOUR ARTERIES The people in the sauna study also showed evidence of artery relaxation after half an hour of spa time, which is an indicator of good heart health. You do not want arterial stiffness, because it raises your risk of cardiovascular issues and diseases. THEY MAY BE GOOD FOR YOUR LIFESPAN A few different studies have shown that there's a link between frequent sauna-taking and a lower risk of early mortality, though it's only been studied in men. THEY HELP SOOTHE CHRONIC CONDITIONS Sauna bathing has been linked to an improvement in pain and symptoms associated with musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, and fibromyalgia, a new study says. And chronic-type headaches are also included in their painbusting properties. THEY COULD HELP YOUR BRAIN Better blood flow doesn't just help your body; it also helps your brain. The research rounded up by this latest study shows that, in older Finnish men, having many sauna sessions a week was linked to a substantially lower risk of Alzheimer's and dementia. THEY SEEM TO PROTECT YOUR LUNGS Having a sauna when you've got a cold or are in the middle of cold season might seem counterintuitive, but research suggests it's a good idea. Studies have shown that saunas can improve your lung function, even if you have asthma or chronic breathing problems, and reduce your risk of contracting a cold or pneumonia if you have them regularly in winter.
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Undescended testes tied to higher cancer risk, infertility Young boys with undescended testes are at increased risk for testicular cancer and infertility in adulthood, new research suggests. Undescended testes are the most common birth defect in infant boys, affecting one in 100. Corrective surgery is required. For the new study, researchers examined data on nearly 351,000 boys who were born in Australia between 1970 and 1999, and followed until 2016. Boys born with undescended testes had 2.4 times the risk of adult testicular cancer compared with other boys, the University of Sydney researchers reported. And that risk rose 6 percent with each sixmonth delay of corrective surgery. The operation, called an orchidopexy, moves an undescended testicle into the scrotum and permanently fixes it there. Guidelines recommend the surgery before 18 months of age. Boys with undescended testes were 20 percent less likely to father children, and were more than twice as likely to use assisted reproductive technology, according to the study.
Take a Vacation: Live Longer
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Let’s face it: adulting is hard. The amount of stuff we’ve got to handle on a daily basis - between work, family, friends, and juggling finances, not to mention the time we need for self-care - how are we supposed to fit it all in? Never mind taking a break from day-to-day life to actually take a real vacation. While it can be tough to bust out of our weekly routines and take that much needed time off, not only are vacations a relaxing break from the daily grind, they can also help you live longer. According to new research, one of the health benefits of taking a vacation includes a longer life, and that’s no small thing, right? Kind of puts things into perspective. And while daily self-care habits like exercise and getting enough sleep are a great way to manage our stress loads and help us live longer, healthier lives overall, research shows that there’s really no substitute for taking vacations. According to a follow up study based on the findings of the Helsinki Businessmen Study - a 40-year long study tracking cardiovascular risk factors in 1,222 businessmen - vacations aren’t just a luxury. In fact, they’re pretty vital for both quality of life and longevity.
Mountain Dew does not kill sperm Mountain Dew does not affect fertility. it has acquired the reputation of impacting fertility mainly due to caffeine and yellow dye 5. it does not contain enough caffeine and yellow dye 5 to affect fertility. The Nutrition Journal reviewed 28 studies that looked at different sperm measurements. The researchers concluded that results were not consistent enough to be conclusive, despite some evidence of negative effects. Mountain Dew has a higher amount of caffeine in a 12-ounce (oz) serving than some other soft drinks, which has lead to people taking it as proof that Mountain Dew affects fertility. Yellow dye 5 is one of the most commonly used food additives. The chemical name of yellow dye 5 is tartrazine. Tartrazine is what gives Mountain Dew its yellow color. Also, people often cite that tartrazine is a potential allergen as part of the myth. The U.S. food and Drug Administration (fDA) have approved color additives, including tartrazine, for use in both food and drugs.
BRIEFS OR BOXER SHORTS? A NEW STUDY SETTLES THE DEBATE What type of underwear is best for men's fertility: briefs or boxer shorts? New research settles the dispute once and for all. Infertility affects 8–12 percent of couples all over the world. Of these cases, 40–50 percent are down to the male. Several factors can affect a man's fertility, such as smoking, their genes, a history of sexually transmitted infections, and heavy drinking. There is also the popular belief that the kind of underwear that men wear can have an impact. Now, new research examines the effect of different types of underwear on the quality of men's sperm. The lead author of the research is Dr. Lidia Mínguez-Alarcón, who is also a research scientist at the Harvard T.H. Chan School of Public Health in Boston, MA. Dr. Mínguez-Alarcón and colleagues examined 656 men aged 18 - 56 who did not have a history of vasectomies and were looking to be treated for infertility at the Massachusetts General Hospital in Boston. The researchers published their findings in the journal Human Reproduction. The men provided the researchers
with semen and blood samples and answered a questionnaire on the type of underwear that they were in the habit of wearing. Overall, more than 50 percent of the men said they usually wore boxers. These men had a 25 percent "higher sperm concentration," a 17 percent higher total sperm count, and 33 percent more swimming sperm than men who said they didn't usually wear boxers. Additionally, men who reported frequently wearing boxer shorts had 14 percent lower serum levels of follicle-stimulating hormone (FSH). As the study authors explain, FSH drives the production of sperm, and they believe that the higher concentration of FSH in people who do not wear boxers suggests that the hormone gets activated and tries to make up for the testicular damage that other types of underwear might induce. Importantly, the greatest statistical difference in sperm quality was found between men who wore boxer shorts and men who wore jockeys or briefs.
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Fresh or frozen? Some women benefit from a fresh embryo transfer while others benefit from delay. The world's first baby born via invitro fertilization turned 40 years old this summer. Still, after four decades, iVf is a relatively new field with ongoing debate on how to get the best results for families who have placed their hopes - and often their personal savings - into fertility treatment. iVf experts disagree about whether transferring a fresh or frozen embryo to a patient's womb offers the best opportunity for healthy babies. According to a study of almost 83,000 iVf patients published August 20 in the journal fertility and Sterility, there is no one-size-fits-all solution. The best technique may vary, depending on how many eggs the patient produces. for a fresh transfer, patients take hormones for several weeks to stimulate egg production. Doctors retrieve the eggs, fertilize them and place one or more embryos in the mother during the same procedure. But many clinics now universally recommend freezing all embryos and waiting a few weeks for the patient to enter a new
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menstrual cycle. "in the past five years, some clinics have advocated for freezing everything with the belief that the process that stimulated the eggs makes the lining of the uterus less welcoming for pregnancy," said Suheil Muasher, M.D., a reproductive endocrinology and infertility specialist at Duke and senior author of the paper. Some research has also indicated frozen embryo transfers are less likely to result in preterm labor and underweight babies, he said. But according to the Duke study, waiting may be advantageous only for women who produce 15 or more eggs after hormone stimulation. Birth rates for these so-called 'high responders' who received frozen embryos were slightly higher (52 percent) than those who received fresh transfers (48 percent). However, in low and intermediate responders - women who produced 14 eggs or fewer - fresh transfers led to better pregnancy and birth rates compared to those who received frozen embryos.
New type 1 diabetes therapy shows promise for long-term reversal A collagen formulation mixed with pancreatic cells is the first minimally invasive therapy to successfully reverse Type 1 diabetes within 24 hours and maintain insulin independence for at least 90 days, a pre-clinical animal study shows. Purdue researchers in collaboration with the IU School of Medicine successfully injected a collagen solution mixed with pancreatic cells into diabetes-induced mice, achieving normal glucose levels for at least 90 days. What if instead of daily insulin injections or wearing pumps, just getting a shot every few months could reverse Type 1 diabetes for you or your dog? It might take ushering in healthy pancreatic cells like a Trojan horse. The Trojan horse, in this case, would be collagen, a protein that the body already makes for building muscles, bones, skin and blood vessels. A collagen formulation mixed with pancreatic cells, developed by Purdue University researchers in collaboration with the Indiana University School of Medicine, is the first minimally invasive therapy to successfully reverse Type 1 diabetes within 24 hours and maintain insulin independence for at least 90 days, a pre-clinical animal study shows.
More protein after weight loss may reduce fatty liver disease
Sleeping five hours or less a night associated with doubled risk of cardiovascular disease
Increasing the amount of protein in the diet may reduce the liver's fat content and lower the risk of diabetes in people with nonalcoholic fatty liver disease. The study is published in the American Journal of Physiology - Endocrinology and Metabolism. NAfLD - sometimes referred to as a "fatty liver" - occurs when more than 5 percent of the liver's total weight is made up of fatty tissue. Excessive fat in the liver can lead to scarring, which may increase the risk of liver cancer or liver failure. People with NAfLD are more likely to develop type 2 diabetes, and people with type 2 diabetes are more likely to develop NAfLD. in fact an estimated 70 percent of people with type 2 diabetes also have a fatty liver. Obesity is also a major risk factor for NAfLD. Previous studies have found that shortterm protein supplementation helps reduce the fat content in the liver, but there have been few studies on the long-term effects of protein on NAfLD. Researchers conducted a two-year study to determine the long-term impact of dietary protein on a fatty liver after weight loss. Twenty-ďŹ ve adult volunteers - 15 of whom had been previously diagnosed with NAfLD - participated in a low-calorie diet for eight weeks to lose up to 8 percent of their body weight. After weight loss, the volunteers were directed to maintain their weight for two years and to follow either a moderateor high-protein diet averaging from 0.8 to 1 grams of protein per kilogram (2.2 pounds) of body weight. The research team took blood and urine samples and performed body scans to assess liver fat content and the amount of protein eliminated from the volunteers' bodies at three intervals: the start of the weight maintenance phase and again six months and then two years later. After two years maintaining their weight loss, the increase in dietary protein was associated with reduced liver fat content in the volunteers. in addition, more than half of the participants who were previously diagnosed with NAfLD no longer had a fatty liver.
Middle-aged men who sleep five hours or less per night have twice the risk of developing a major cardiovascular event during the following two decades than men who sleep seven to eight hours, according to research presented today at ESC Congress 2018. Study author Ms Moa Bengtsson, of the University of Gothenburg, Sweden, said: "For people with busy lives, sleeping may feel like a waste of time but our study suggests that short sleep could be linked with future cardiovascular disease." Previous studies have generated conflicting evidence on whether short sleep is associated with a greater chance of having a future cardiovascular event. This study investigated this relationship in 50-year-old men. In 1993, 50% of all men born in 1943 and living in Gothenburg were randomly selected to participate in the study. Of the 1,463 invited, 798 (55%) men agreed to take part. Participants underwent a physical examination and completed a questionnaire on current health conditions, average sleep duration, physical activity, and smoking. The men were divided into four groups according to their self-estimated average sleep duration at the start of the study. Participants were followed-up for 21 years for the occurrence of major cardiovascular events. Data on cardiovascular events were collected from medical records, the Swedish Hospital Discharge Registry, and the Swedish Cause of Death Register. High blood pressure, diabetes, obesity, current smoking, low physical activity, and poor sleep quality were more common in men who slept five or fewer hours per night compared to those who got seven to eight hours. Compared to those with normal sleep duration, men who slept five or fewer hours per night had a two-fold higher risk of having a major cardiovascular event by age 71. The risk remained doubled after adjusting for cardiovascular risk factors at the start of the study including obesity, diabetes, and smoking.
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Eggs have gotten a bad rap in some circles. Yes, they do have some cholesterol and fat. But they also have loads of nutrients and protein.
fits e n e B Health
They Offer Complete Protein One egg has 6 grams of the stuff, with all nine “essential” amino acids, the building blocks of protein. That’s important because those are the ones your body can’t make by itself. The egg white holds about half that protein and only a small portion of the fat and cholesterol. They're Nutrient Dense That means eggs have more nutrients -- vitamins, minerals, amino acids -per calorie than most other foods. They Help Your 'Good' Cholesterol This “good” cholesterol, called HDL, seems to go up in people who have three or more eggs a day. Of course, LDL, the “bad” type, goes up, too. That makes it harder for the bad stuff to hurt you and easier for the good stuff to clear it away. They Can Lower Your Triglycerides Your doctor tests you for these along with HDL and LDL. Lower triglycerides are better for your health. Eating eggs, seems to bring down your levels.
of
exactly what you are getting. And they travel easy, too. Hard boil a couple and stick ‘em in your cooler. Add a salad or a couple of slices of bread and you’ve got a quick, healthy lunch. They're Affordable At Rs 6 a piece, you can’t beat it for a high-quality protein that won’t break the bank. And you don’t have to worry about sugar or carbs because eggs don’t have either. They’re Heart Healthy Surprised? It’s true. Overall, people who eat more of them don’t seem to raise their chances of heart disease. They Satisfy Have them for breakfast and you’ll feel full longer. That'll make you more likely to eat less throughout the day. They Help Your Eyes Doctors know that the antioxidants lutein and zeaxanthin help keep you from getting eye diseases like cataracts and age-related macular degeneration. Green, leafy vegetables like spinach and kale have them, too. But eggs are a better source.
After a study done at Cornell University, researchers found that people who enter their homes through an entry way that is close to the kitchen tend to eat 15% more than those who enter farther away from the kitchen.
They Can Lower Your Odds of a Stroke Though studies vary, it appears that a They Help Sharpen the Brain daily egg might lower your risk. Eggs have vitamin D, which is good for your gray matter and hard to get from They Help With Portion Control food. And they have something called At about 70 calories per egg, you know choline that helps the nerve cells.
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ruitastic smoothies FRUIT OATMEAL BREAKFAST SMOOTHIE: Ingredients: 1 cup vanilla soy milk, 1/2 cup rolled oats, 1 banana, 1/2 apple, 1 1/2 teaspoon sugar (optional). In a blender combine soy milk, banana, apple and oats (add sugar if required). Blend till smooth. Pour into glasses and serve.
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GROOVY GREEN SMOOTHIE: Ingredients: 1 cup grapes, yogurt, 1 banana, 1/2 apple, 1 1/2 fresh spinach leaves. In a blender combine all. Blend till smooth. Pour into glasses and serve.
WAKE UP CALL: This is the perfect breakfast smoothie for a busy day. Ingredients: 1 cup mango chunks, 1 cup strawberries, 1/4 teaspoon grated ginger, squeeze of lime juice, 200 ml almond milk, ice. In a blender combine all. Blend till smooth. Serve chilled.
FRUIT BLAST: Ingredients: 1 banana, 1/2 cup yogurt, 1-1/2 teaspoon sugar, 1/2 cup pineapple, 1 cup apple, 1 cup strawberries, 1 tablespoon orange juice, 1 tablespoon milk. In a blender combine all. Blend till smooth.
IMMUNE BOOSTER: Ingredients: 1 cup mango chunks, 1 cup pineapple chunks, 1/4 teaspoon grated ginger, 2 tablespoons honey, 250 ml almond milk, ice. In a blender combine all. Blend till smooth. Serve chilled.
Recipes: SUMAN THAKUR Photography: NEELENDRA SINGH
You're exercising regularly, and seeing changes in your physique. but did you know exercise can also help in these other ways?
Bonus Benefits of Exercise 1 2
more energY You might not expect it, but using energy to exercise gives you more get-up-and-go.
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better mooD Exercise makes you feel happier. When you work out, your body makes endorphins "feel-good" chemicals in the brain.
more confiDence You just walked a mile or ran your first 5K. Success like that can boost your self-esteem and make you ready to conquer anything. Exercise makes you feel good about yourself.
more ProDuctiVe Want to be more efficient at work? Take a break and get some exercise.
strong bones anD muscles Your bones and muscles get stronger when you work out. it's especially important to do weightbearing exercise, such as weight-lifting, tennis, walking, and dancing. lower risk of cancer Regular exercise can cut your risk of some cancers, including colon, breast, and lung.
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gooD night's sleeP Get regular exercise to help you fall asleep faster and sleep more soundly.
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less stress Exercise calms your body and your brain. After your body works hard, the levels of stress hormones, adrenaline and cortisol - drop. weight control Exercise and diet work together to keep your weight healthy.
long life Regular exercise can add years to your life. And that counts even if you're not a hard-core fitness buff. Just get moving.
healthY heart it's no secret that exercise is great for your heart. Regular workouts lower your risk of heart disease, improve your blood cholesterol levels, and help control and even prevent high blood pressure. less arthritis Pain if you have arthritis, regular exercise can help ease your pain and make daily activities easier.
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CANON EOS 5D MARK IV 30.4 MP Digital SLR Camera (Black) + EF 24-105mm is II USM Lens Kit
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• 30.4 MP full-frame CMOS sensor for versatile shooting • Up to 7.0 frames per second continuous shooting speed • 61-point AF system with 41 cross-points for expanded vertical coverage • ISO range 100-32000 with 50-102400 expansion • 4K video recording at 30p or 24p and incamera still frame grab of 8.8MP images • Touch-screen LCD monitor.Built in Wi-Fi and NFC Price: Rs 277,500.00 www.amazon.in
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Jiggly arms look as bad as a flabby tummy. They make you look older, unfit, and on top of that sleeveless clothes are just out of the question! This can affect your confidence and create a negative body image.
Best Excercises for
Jiggly Arms 1
tricePs DiPs if you are working out at home, place your arms on a chair or bench and elevate your feet by putting a stool under them. steps • Assume the starting position by placing your arms behind your back, gripping a bench or the rack. • from the starting position, slowly lower yourself. Keep your body upright and your elbows, tucked close to your sides. • Concentrate on lowering your body only with the triceps. Ensure that your elbows are at a 90-degree angle. • After this, push your body back up using only your triceps. Repeat.
2 one-arm Push-uP The one-arm push-up is a useful exercise for targeting the triceps and getting rid of those flabby arms. steps • Place your hands with the palms facing downward on the floor, shoulder-width apart, and raise one arm and place it on your back. Keep your feet together. Support your weight on your hand and toes. • Lower yourself until your chest is almost touching the floor. inhale as you do this. • Exhale and push your body up back to the first position. Steady yourself at the top and repeat.
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Push-uPs Push-ups are primarily chest exercises, but they also work the triceps as a secondary muscle. steps • Place your hands with the palms facing downward on the floor, shoulder-width apart, with a slight bend in your arms. Keep your feet together. Support your weight on your hands and toes. • Lower yourself until your chest is almost touching the floor. inhale as you do this. • Exhale and push your body up back to the first position. Steady yourself at the top and repeat.
4 triceP kickbacks Tricep kickbacks require two light dumbbells. if you don’t have any at home, you can use one-liter water bottles. steps • Hold a dumbbell in each hand. • While you are standing, bend your knees slightly, keeping your back straight, and bend forward slightly. Your body should be almost parallel to the floor. Keep your head up and your arms close to your sides such that there is a 90-degree angle between your forearm and upper arm. • Keep your shoulders locked to your sides while extending your arms back. focus on the contraction of your triceps only. • Hold for two seconds and lower your arms to the starting position. Avoid swinging your arms. Repeat.
6 bent oVer row To perform a bent over row, you will need a barbell. A set of dumbbells can also be used as an alternative. steps • Stand with your feet shoulder-width apart and grab a barbell with your palms facing down. • Bend forward and slightly bend your knees. Keep your back straight. Your torso should be parallel to the floor, and your head pointed up. • Keep your elbows close to your body. Breathe out, and pull the bar towards your chest, just below your ribs. Exhale as you do this. • At this position, squeeze your back muscles and hold. • Lower the bar down to the starting position, just around your knees. Repeat.
5 triceP extensions Tricep extension is an amazing exercise for triceps and helps to make the triceps stronger and more toned. steps • Stand with your feet shoulder-width apart. • Hold a dumbbell with both hands, with the thumbs wrapped around it for better grip. The dumbbell should be held behind your head, and your palms must face the ceiling. • Your upper arms should be close to your head. The elbows should be close to your eyes and perpendicular to the floor. • Lower your upper arms until the weight is touching the upper part of your back. Don’t move your elbows. Keep them locked close to your ears. • Use your triceps to raise the dumbbell up with your arms fully extended over your head. Exhale as you do this.
Men
oYsters + PumPkin seeDs both are very high in zinc, which may increase testosterone, sperm motility and sperm count.
oranges, broccoli + strawberries all three contain vitamin c, which may help in sperm development. Dark, leafY Vegetables like sPinach, collarD greens + kale the folate in these vegetables can help produce strong, healthy sperm
Dark chocolate Dark chocolate contains arginine, an amino acid that can improve sperm count and quality.
salmon + sarDines the omega-3 fatty acids in these foods may help improve quality and quantity of sperm.
Pomegranate juice the antioxidants in pomegranate juice may improve sperm quality and testosterone levels. brazil nuts the selenium in these nuts can help increase sperm count, sperm shape and sperm motility.
water staying hydrated helps create good seminal uid.
Women
seaweeD seaweed is packed with nutrients that help enrich the liver, kidneys, bladder, and adrenals which are organs vital to fertility health. salmon salmon is full of omega-3 fatty acids which are proven to regulate blood ow to the reproductive organs. figs figs have been believed to increase fertility since the time of ancient greeks, and now we have scientiďŹ c evidence. figs contain a lot of iron, which are important for healthy eggs and ovulation.
foods to boost your libido And fertility
oYsters oysters have been known to increase libido, but oysters can also be a great source for fertility because they are packed with zinc, which increases the production of good-quality eggs.
berries any kind of berries are good at protecting eggs from damage and aging because they are full of antioxidants. strawberries have been linked to naturally increasing a woman’s libido. beans beans are a lean protein and are full of iron, which helps to increase fertility and libido. low iron levels can result in anovulation, which is when ovulation does not produce a healthy egg.
Yams research shows yams have an ovulation stimulating substance that can help boost fertility.
leafY greens Dark leafy greens such as spinach, romaine, arugula, and broccoli are high in folate, a b vitamin that has been shown to improve ovulation.
An old saying says “injuries are our best teachers”. These unfortunate injuries can have a less painful course if we know what to do immediately. initial management of any injury start right at the time of injury and each step can increase or decrease the agony of the injured. Hence once should know the right steps to be taken care of following injury/fracture. The first step is to look for any active bleeding and controlling it. Compression with clean cloth and coverage of the wound. Cold application helps to decrease bleeding. Look for the sensorium of the injured by asking him simple questions as his name, address etc, to rule out any associated head injury or shock. The basic principle that is followed after fracture is rice. r- Rest i- icing c- Compression e- Elevation rest: first step should be rest to the injured or sprained or bruised area. in case the affected part get deformed or distorted than it is suggestive of a fracture or dislocation. in such cases that particular part need to be splinted with a hard straight object (measuring ruler, wooden piece etc). icing: ice /cold compression causes decrease of swelling, pain and bleeding due to constriction of blood vessels. icing should not be allowed directly on the skin and can be applied for 10-20 mins four to five times a day. compression: Compression along with splinting helps to allay pain and control swelling and bleeding . compression should be tight enough not to hamper the circulation of the part blow the injury. elevaton: Elevation of the affected limb helps to decrease the swelling, prevents the blood pressure from falling, and controls shock. Along with these measures ensure an ambulance has been called. Dont’s in anY injurY: • Don’t attempt to force a fracture or dislocation back into place • in case it is difficult to asses the severity of injury, treat the patient as he is having a fracture till hospitalisation • Never use hot compress at the site of injury • Never try to make the injured stand or use his affected part immediately
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basic protocol for a Fracture /Dislocation Dr Pranay Bhushan Pandey
Antioxidant supplements fail to improve sperm quality in infertile men Trial results offer no support for antioxidant supplementation in male factor infertility Despite many study results suggesting that antioxidants have a positive effect on abnormal sperm parameters associated with male infertility, a large US clinical trial of 174 couples has found that an antioxidant formulation taken daily by the male partner for a minimum of three months made no difference to sperm concentration, motility or morphology, nor to the rate of DNA fragmentation. Results of the study, which was performed in eight American fertility centres with the support of the National Institutes of Health, were presented at the 34th Annual Meeting of ESHRE, by Professor Anne Steiner from the University of North Carolina at Chapel Hill, USA. As background to the trial, the authors explain that many of the previous studies in which antioxidants have been linked to improvements in sperm quality have been limited by small numbers, heterogeneity in patients, variety of antioxidant, and non-clinical endpoints. This study, therefore, was designed to close these gaps in knowledge and provide a stronger evidence base.
How do muscles know what time it is?
How do muscle cells prepare for the particular metabolic challenges of the day? Scientists at Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU), members of the German Center for Diabetes Research (DZD), have investigated this question and published their results in 'PLOS Biology'. The study has uncovered a metabolic network which is, contrary to expectations, not controlled by the brain but rather by the 'circadian clock' of muscle cells. Circadian clocks are present in all cells of the body, and have a pervasive influence on all aspects of human physiology. This is because they regulate homeostasis by anticipating rhythmic changes in behavior and nutritional state, and by compartmentalizing incompatible metabolic pathways within precise temporal windows. "This applies, for example, to the use of nutrients such as fats and carbohydrates," explains Professor Henriette Uhlenhaut. "If the body's internal clock gets out of synch, however, it can have serious consequences for the body's metabolism. For example, it is known that shift workers are particularly susceptible to metabolic diseases such as diabetes." "Taken together, our work has revealed an entire metabolic network at multiple levels," Uhlenhaut explains. "Another biologically exciting finding is that, contrary to expectations, the key regulator is not centrally located in the brain, but is in fact the internal clock of the muscle cells themselves." In the long term, the authors will investigate the mechanisms also in humans and try to find a way for therapeutic interventions. Their hope is that it might be possible to counteract insulin resistance in type 2 diabetes or to stimulate energy use to combat obesity.
4 Signs You're in an Unhealthy Relationship Time spent together leaves you feeling badly about yourself. There are characteristics about yourself that you value – perhaps it’s your generosity, your optimistic nature, or your cooking abilities. When your partner devalues these traits and leaves you feeling disrespected, you will feel worse about yourself for being in the relationship. You or your partner is not capable of an interdependent relationship. The strongest relationships are ones that support both independence and dependence. Each partner feels supported as an independent individual and is encouraged to depend on the other for comfort and encouragement. When either of these aspects of a relationship is missing, the relationship is weakened and will likely deteriorate over time. Your partner is not ready for a committed relationship, but you are. Partners are often out of sync with each other at different points in time. However, if you remain in a relationship for an extended time, hoping that your partner will change their mind, then you may find that it takes a huge emotional toll on you. At some point, you may need to decide whether it is unhealthy for you to continue in the relationship – despite how much you care. You and your partner do not communicate well. Good communication is key in helping partners to become emotionally close. Also, when tensions arise, it is essential that you can both talk through differences constructively. These conversations don’t need to go perfectly smoothly, but you do need to be able to work together to keep them on track. Otherwise, the strains and stresses of your relationship will create an unhealthy situation.
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haPPY hour A night out or beers with the bros could give you more than a hangover. Even though it's a liquid, alcohol can actually dry out your mouth, which encourages the bacteria that cause halitosis, the medical term for bad breath. Drinks with caeine, spicy foods, and cigarettes can, too. A dry mouth from not making as much saliva while you sleep also explains "morning breath."
Your tongue Bacteria on the tongue is the leading cause of bad breath. Clean yours with your toothbrush or a tongue scraper. Scrapers will do a slightly better job.
a low-carb Diet When you cut out carbs and boost the amount of protein you eat, your body starts burning fat for energy. That process makes compounds called ketones, which cause bad breath.
the common colD As if they weren't annoying enough, respiratory tract infections like colds and bronchitis can also give you bad breath. That's because odorcausing bacteria like to feed on mucus.
an ulcer OK, the ulcer itself may not be the problem. But a type of bacteria that causes ulcers, Helicobacter pylori, can also trigger bad breath, according to a study in the Journal of Medical Microbiology.
Bad breath isn't just about what you eat. These medical and other issues could be giving you bad breath and halitosis.
Bad Breath
aciD reflux or heartburn These are two symptoms of GERD (gastroesophageal reux disease), a common digestive disorder. Your bad breath may be from some undigested food coming back up.
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crackeD teeth anD fillings These can trap food particles and breed bacteria, resulting in cavities, gum disease, and bad breath.
tonsil stones These small white-ish clusters made up of hardened bacteria, food particles, dead cells, and mucus - get trapped in the ridges of your tonsils and the back of your tongue. They're generally harmless except for the smell.
FaCtS, reaLItY aNd MYthS
6 PACK AB ETCHING! DR PARAG TELANG Cosmetic & Plastic Surgeon, SL Raheja Hospital, Mumbai
CASE STUDY: A 27yr old male patient with a physically active lifestyle with regular workout, was still unable to achieve a perfect 6-Pack Abs look. I performed a detailed examination of the abdominal musculature and marked the abs on his abdomen. I performed a High Definition Abs Contouring procedure for him. After undergoing this 45 mins procedure under sedation, we could give him the perfect abs, something he was trying for more than 2 years! Because of the safety and effectiveness of this procedure, it has become a very popular and high in demand cosmetic surgery these days.
What is this recent trend of 6 Pack Abs etching? Since time immemorial, men have been obsessed with having a chiseled abdomen with 6 pack abs. All men have these abs, but they are covered under layers of fat. Due to the recent advances in fat removal technology, it is now possible to make these packs visible. More than 30% of enquiries among male patients are regarding 6-Pack Abs Etching. It is an hour-long procedure done under mild sedation. We use a technology called as ‘High Definition Liposelection’, in which the ab muscles are first marked on the patient’s abdomen while in standing position. 2mm punctures are made in hidden areas from where Ultrasonic Needles are inserted to liquefy fat that is covering the ab muscles. This means selective removal of fat to make the creases in the ab muscles stand out. Once this sculpting is done, the definition of the muscles can be seen nicely. What is the recovery period? 6-Pack Abs etching is typically a day-care procedure. The patient is provided with an abdominal corset that is to be worn for 6 weeks, post-procedure. This helps in giving good support to the skin, so that the abdomen has a taut and sculpted look. There may be some sensitivity of the abdominal skin for a week, some swelling and discomfort for 68 days after this procedure. When can one resume exercises after this procedure? One can resume walking or treadmill use after 3-4 days, Cardio and Yoga after 8 days and abdominal core muscle
exercises after 3 weeks to 1 month. Are these 6 packs for life? If one is regular with core muscle exercises of the abdomen and maintains their ideal body weight, then it is possible to maintain these sculpted abs for many years. The muscle tone depends on the activity level of the patient. If one puts on 8-10 kg body weight, then there is a possibility of these packs getting covered by a layer of fat, again. What is the overall cost of 6 packs abs etching? The cost ranges from Rs 75,000 to 1.5 lacs. Who are good candidates for this procedure? Any person who is physically active and has good abdominal muscle tone, can undergo this procedure. Someone with a protuberant belly with lack of physical exercise, is not a good candidate for this procedure. 6-Pack Abs Etching now comprises of more than 30% of the total number of male cosmetic surgeries/procedures. Is there any Ab Etching procedure for women? Yes, the same technology can be used for women, to remove unwanted belly fat and to get a sculpted look. What other procedures are offered in high definition sculpting? It is possible to sculpt the Calves, Biceps and Triceps muscles using the same technology. As we gain more experience, I am sure many more applications will be made available for the patients.
6 OF THE BEST
PLANK EXERCISES FOR FLAT ABS
Single Arm
Single Leg
Single Arm Single Leg
Spiderman
Model: Rajan Dwivedi Photographer: Neelendra Singh
Superman
buY it here worm bites: 3-Pack of Assorted flavors (North American Roasted Mealworms). Gift Set includes Cayenne, Roasted Original & Buffalo Wing Sauce flavor. $ 13.95 www.amazon.com
Stull, a doctoral graduate of the University of Wisconsin-Madison Nelson institute for Environmental Studies, is the lead author of a new pilot clinical trial published in the journal Scientific Reports that looks at what eating crickets does to the human microbiome. it shows that consuming crickets can help support the growth of beneficial gut bacteria and that eating crickets is not only safe at high doses but may also reduce inflammation in the body. More than 2 billion people around the world regularly consume insects, which are also a good source of protein, vitamins, minerals and healthy fats. The research team was interested in documenting for the first time via clinical trial the health effects of eating them. Raising insects for protein not only helps protect the environ-
a new clinical trial shows that consuming crickets can help support the growth of beneficial gut bacteria and that eating crickets is not only safe at high doses but may also reduce inflammation in the body.
cricket PowDer 100g $4.90 www.thailandunique.com
100% scorPion PowDer 10g $22.00 www.thailandunique.com
ment, but also offers a more healthful option than meat in many wealthy countries with high-meat diets, says co-author Jonathan Patz, director of the UW-Madison Global Health institute. Crickets, like other insects, contain fibers, such as chitin, that are different from the dietary fiber found in foods like fruits and vegetables. fiber serves as a microbial food source and some fiber types promote the growth of beneficial bacteria, also known as probiotics. The small trial probed whether insect fibers might influence the bacteria found in the gastrointestinal tract.
Eating crickets is good for your health
DRY WEATHER Cold, dry weather can lead to major itching all over your body, including on the breasts and nipples. If that’s the cause, your nipples may look raw or chafed. Keep baths and showers to under 10 minutes. Use lukewarm water, gently pat your skin with a towel until it’s almost dry, and moisturize with a thick cream or ointment. Run a humidifier to add moisture.
UK Man gets £50k bionic manhood in rare surgery He spent 44 years without a penis
The largest cell in the body is the female egg and the smallest is the male sperm.
A man who was born without a penis has had sex for the first time aged 45 - thanks to his new £50,000 (Rs 50 lac approx) bionic manhood. Andrew Wardle went through a painful ten-hour operation to be given the new device which was created using skin from his arm. After living as a virgin for all his life, Andrew, had the final part of his penile implant fitted at London's University Hospital. Now he has finally been able to do the deed with his girlfriend Fedra Fabian, using a button to pump it up, and is delighted with the result. After having sex for the first time Andrew also hopes to become a dad one day. Following his surgery, Andrew had to walk around with an erection for 10 days - and faced another six weeks until he could put it into action with girlfriend Fedra, 28. He now, uses a button in his groin to inflate the organ with saline fluid through a valve in his scrotum. “I had to test out the function every morning and night and leave it erect for 20 minutes. So one morning it just happened. It was nice and natural and that’s how I wanted it to be." As well as experiencing pleasurable feelings, the organ is connected into his testicles which means there is a possibility of him having children. Andrew was born with bladder exstrophy, a rare birth defect that means the organ, that usually sits inside the pelvis, is exposed. Although he has testicles, the condition means he has no penis. Andrew has undergone a string of operations over the last four years to build his appendage. While bladder exstrophy typically affects one in every 40,000 births, Andrew said rare complications with his case only happens to one in around 20 million. Although the pioneering operation, in which surgeons have used muscle, nerves and skin from Andrew’s arm, marks a new chapter in his life, it hasn't been an easy journey. (Courtesy “The Mirror”, UK)
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ECZEMA It can cause a crusty rash on your nipples and the flat part around it, especially if you’ve had eczema before. Use a thick moisturizer with ceramides, a waxy ingredient that helps heal the skin. A topical steroid cream like hydrocortisone can help with swelling and itching. Your doctor can prescribe stronger prescription ointments. See them right away if you notice any oozing or tenderness, which could be a sign of infection. SOAP Your new soap, lotion, or laundry detergent could be behind your itch. The chemicals in many cleansing products can cause a rash called contact dermatitis. Switch to soaps and cleansers that are hypoallergenic, unscented, and free of dyes, and you’ll know if that’s the problem. UNDERGARMENTS Your breasts and nipples may be reacting to the elastic or dye used to make your bra or lingerie. Contact dermatitis can cause redness and itching on the areas of the skin that touch the fabric, like your nipples. PREGNANCY Weight gain, morning sickness, hormone swings, and ... itchy nipples? Yep, add that to the list of symptoms of pregnancy. Blame it on hormone changes and skin stretching as your breasts and nipples expand to get ready for a nursing baby. Cocoa butter, coconut oil, or a lanolin ointment rubbed on the nipples can help. BREASTFEEDING Milk residue, plugged milk ducts, and problems with your baby latching on during feedings all can make nipples itchy and sore. It’s important to keep the area clean and dry and to continue to pump or nurse. Lanolin ointment and silicone gel pads cooled in the refrigerator can help ease your discomfort. THRUSH If you’re breastfeeding, and if your nipples and surrounding area are not only itchy but shiny or flaky, and you feel sharp pain while nursing, see your doc-
tor. Those are signs of thrush, a fungal infection. MENOPAUSE This stage of your life can make your skin thinner, drier, and more easily irritated. Blame it on your hormones again. Your body makes less oil, so it’s harder for your skin to retain moisture. The itch can strike just about anywhere on the body, including the vagina and nipples. Fight the dryness by using mild cleansers, moisturizing often, and taking fewer hot showers.
What’s Making You Scratch?
Why Do Nipples Itch? Mehga Vaswani lists the causes...
RADIATION Treatment for breast cancer can lead to severe itching in the breasts and nipples, even long after it ends. Radiation kills skin cells and causes dryness, burning, and itching as the skin peels off. Massage the area with an ice cube, wear soft, loose-fitting clothes, and drink plenty of fluids. Oral antihistamines can help. Your doctor also can prescribe a corticosteroid to rub on the skin. PAGET'S DISEASE This rare form of breast cancer starts in the breast ducts and spreads to the nipple and nearby area. It can look a lot like eczema. But it often affects just one nipple, and you may also see blood or yellow discharge. If the rash doesn’t respond to eczema treatments, you may need a biopsy of a tissue sample to be sure. Paget's disease usually is treated with surgery, followed by radiation. BENIGN TUMOR Sometimes, a noncancerous tumor in the breast duct can cause an itchy, crusted nipple. You may feel a small lump or notice a clear or bloody discharge from the nipple. To make the diagnosis, your doctor may X-ray your breast duct or order an ultrasound, mammogram, or biopsy. The treatment is usually surgery.
Lots of things can make your nipples itchy. They’re sensitive in general. They also stick out, and they can get irritated from friction, eczema, breastfeeding, or pregnancy. Rarely, itchy nipples can be a sign of a more serious condition. Even if your urge to scratch is great, the problem is usually easy to treat.
name: Dr sujata kar Profession: Gynaec & Endo-ART Specialist location: Bhubaneshwar, Odisha age: 55 what is your fitness routine? i try to workout for about an hour, at least 4-5 times a week, cardio and strength training at home. i work in a seven storey building and never ever take the lift.
FIT
@ 50
Do you follow a particular diet plan? No diet plan. i believe in eating small portions multiple times. My diet heavy on nuts and fruits and i avoid deep fried, pickled, frozen and processed food. how does your fitness routine help you de-stress? Over the years, working out becomes an addiction. Exercise relaxes, helps me sleep well and gives me peace of mind. You also come to love the “muscle burn” after a good workout.
suPPort actiVitY leVels with the right Diet Diet as well as exercise can have a major impact on energy, mood, and fitness. Older adults without kidney disease or diabetes should aim for about 0.5 grams of protein per pound of body weight. • Vary your sources of protein instead of relying on just red meat, including more fish, poultry, beans, and eggs. • Reduce the amount of processed carbohydrates you consume and replace them with high-quality protein. • Snack on nuts and seeds instead of chips, replace a baked dessert with Greek yogurt, swap out slices of pizza for a grilled chicken breast and a side of beans.
builDing a balanceD exercise Plan Staying active is not a science. The key is to find activities that you enjoy, based on the four building blocks of fitness. These are: 1: balance What it is: Maintains standing and stability, whether you’re stationary or moving around. Try yoga, Tai Chi, and posture exercises to gain confidence with balance. 2: cardio What it is: Uses large muscle groups in rhythmic motions over a period of time. Cardio workouts get your heart pumping and you may even feel a little short of breath. includes walking, stair climbing, swimming, hiking, cycling, rowing, tennis, and dancing. 3: strength and power training What it is: Builds up muscle with repetitive motion using weight or external resistance from body weight, machines, free weights, or elastic bands. 4: flexibility What it is: Challenges the ability of your body’s joints to move freely through a full range of motion. This can be done through stationary stretches and stretches that involve movement to keep your muscles and joints supple and less prone to injury. Yoga is an excellent means of improving flexibility.
mYths about actiVitY anD aging myth 1: there's no point to exercising. i'm going to get old anyway. fact: Regular physical activity helps you look and feel younger and stay independent longer. it also lowers your risk for a variety of conditions, including Alzheimer’s and dementia, heart disease, diabetes, certain cancers, high blood pressure, and obesity. myth 2: exercise puts me at risk of falling down. fact: Regular exercise, by building strength and stamina, prevents loss of bone mass and improves balance, actually reducing your risk of falling. myth 3: i’m too old to start exercising. fact: You’re never too old to get moving and improve your health! in fact, adults who become active later in life often show greater physical and mental improvements than their younger counterparts. myth 4: i can't exercise because i'm disabled. fact: Chair-bound people face special challenges but can lift light weights, stretch, and do chair aerobics, chair yoga, and chair Tai Chi to increase range of motion, improve muscle tone and flexibility, and promote cardiovascular health. myth 5: i'm too weak or have too many aches and pains. fact: Getting moving can help you manage pain and improve your strength and self-confidence. The key is to start off gently.
EXCERCISE TIPS warm uP anD stretching Before starting any form of exercise it is most important to warm up your body. Gradual warm up revs up your cardiovascular system by raising body temperature and blood flow to muscles. it also helps to reduce chances of muscle pain, soreness and injury. Stretching the muscles also prepares them for sustained physical activity and great for burning calories. carDio As in running on a treadmill, elliptical or static bycycling is great for
heart health. Low intensity, steady state cardio like brisk walking too is excellent and can be easily done by most people. strength training Or weights are a very important part of physical fitness. Especially as you age. Multiple benefits are there, like increased muscle mass, fat burn, reduced muscle loss as you age, increased bone strength (very important to reduce fracture risk with age), increased tone and reduced sagging of skin.
Model: Dr Sujata Kar Photography: Akhil Ranjan Location Courtesy: Hotel Mayfair Lagoon, Bhubneshwar HE & SHE
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Mental Wellness
I
n recent times, due to the influence of technology, kids have become aloof and do not share much with their parents. It is at this time that the parents need to be cautious to identify signs that might lead to self-harm or worse, suicide. There are times when kids show clear signs of Depression, but parents tend to ignore them or pass them off as usual mood swings. Suicidal symptoms are often seen in youth facing court appearances, family distress, pressure of examinations and peers, those who are sexually abused or those who have been rejected by their loved ones. If there is a doubt that your child is being highly temperamental or suicidal, parents should immediately seek help from counsellors at school or a Mental Health expert, but at the same time they should respect their child’s space and not question or pressurise them frequently. If they are forced to disclose their worries, they might get annoyed and take drastic steps to get out of the situation. SIGNS & SYMPTOMS: Here are a few signs one could look out for in their children. • When they talk about death and dying very often, or even about disappearing or jumping or shooting oneself or any other form of self-harm • If they have encountered any situational crisis of losing a close one through death or divorce, experiencing a broken relationship, lost a close friend and have no interest in meeting other friends. They lose interest in hobbies or other activities they previously enjoyed doing • A drastic change in personality, leaning towards withdrawn, depressed, irritable, apathetic, tired, indecisive or tired conduct • Lack of focus at school, workplace or while doing routine tasks • Some people may tend to over or under sleeping and may also have nightmares. Sleep walking amongst teenagers is not common but is a possibility. Hallucinations, unless under influence of drugs or a psychotic illness, may not be present • Also keep a look out for change in their eating habits, one tends to either overeat or experience loss of appetite, in extremities • They lose their self-esteem and start feeling worthless, shameful, and guilty while doing regular tasks. With build-up of selfhatred, they start to think people will be happier if they aren’t around or if they don’t partake in activities • Belief that things will never get better and that nothing will ever change. TREATMENT: Usually a child coming in for treatment is advised Pharmacotherapy-medication to help ease symptoms of Anxiety, Depression, disturbed sleep etc. Along with this he/she is even provided with individual Psychotherapy where they are counseled on how to cope better with the challenges in their lives and help them recognise the fault thought patterns that are preventing them do so. Family therapy is conducted so that parents and family members understand the young child and learn how to be supportive. Timely identification of symptoms goes a long way in bettering the life of your loved one.
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DePression in chilDren facts Depression is a condition that is more severe than normal sadness and can significantly interfere with a child's ability to function. • Depression affects about 2% of preschool and school-age children. • Depression in children does not have one specific cause but rather a number of biological, psychological, and environmental risk factors that are part of its development. • General symptoms of depression, regardless of age, include having a depressed or irritable mood or loss of interest or pleasure for at least two weeks and having at least five clinical signs and symptoms. • Suicide is the third leading cause of death in young people 10-24 years of age. • To diagnose depression, a health care professional will likely perform or refer for a thorough medical assessment and physical examination and ask standard mental health questions. • Treatment for childhood depression may include addressing any medical conditions that caused or worsened the condition. it can also involve lifestyle adjustments, psychotherapy, and, for moderate to severe depression, medication. • interpersonal therapy (iTP) and cognitive behavioral therapy (CBT) are the major approaches commonly used to treat childhood depression. • About 60% of children who take antidepressant medication improve. it may take up to six weeks of treatment with medication at its effective dose to start improving. • Childhood depression is a risk factor for developing a number of other mental health symptoms and disorders. • Prevention of childhood depression seeks to reduce risk factors and strengthen protective factors using approaches that are appropriate for the child's developmental level. • it is advisable for family members and friends to seek mental health assessment and treatment for the depressed child.
Ms TARA MEHTA Clinical Psychologist at S.L Raheja Hospital, Mumbai
role of Parents in Preventing
SuICIde IN ChILdreN 25% inDian chilDren suffer from DePression One in four children in the age group of 13-15 years in india suffer from depression, which affects 86 million people in South-East Asia region, according to the World Health Organisation (WHO). The estimated suicide rate per 1 lakh people in india, in the age group of 15-29 years, was 35.5. 25 per cent of adolescent were "depressed" and "sad or hopeless" while 11 per cent were "distracted" and had a hard time staying focused on their work most of times or always. Eight per cent adolescents faced "anxiety" or could not sleep because of being worried while a similar percentage of adolescents felt lonely most of times or always, it said, adding 10.1 per cent of adolescents in india had no close friends. The report said a "significant" number of students reported low levels of parental engagement, ranging from 15 per cent in Sri Lanka to almost one fifth students in india.
alarming facts four per cent adolescents in india use tobacco products while eight per cent consume alcohol, the report said.
D
iabetes Mellitusis a disease in which the level of blood glucose or blood sugar are too high. It is of two types; type 1 is where the body doesn’t make enough insulin, type 2 diabetes is more common. It’s when the body doesn’t use insulin well or develops a resistance for it. In both these cases, without enough insulin or insulin which is not well utilized the glucose stays in the blood and affects many body organs. Type 2 DM is a lifestyle disorder. Certain risk factors which predispose to developing diabetes like obesity or having an inactive lifestyle, high blood pressure, smoking, having a history of heart disease or stroke
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and having high levels of triglycerides (bad cholesterol) in your blood. In women, who have had diabetes during pregnancy or PCOS (polycystic ovarian disease syndrome) are also predisposed to developing type 2 DM. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Lastly, having family history of diabetes also predisposes one to have type 2 DM. Glucose comes from food and insulin is a hormone that helps the glucose get into the body’s cells to give
FAST FACTS ON DIABETES • Diabetes is a long-term condition that causes high blood sugar levels. • in 2013 it was estimated that over 382 million people throughout the world had diabetes (Williams textbook of endocrinology). • Type 1 Diabetes - the body does not produce insulin. Approximately 10% of all diabetes cases are type 1. • Type 2 Diabetes - the body does not produce enough insulin for proper function. Approximately 90% of all cases of diabetes worldwide are of this type. • Gestational Diabetes - this type af-
fects females during pregnancy.
also need to take oral medication, and/or insulin to control blood glutoms include frequent urination, in- cose levels. • As the risk of cardiovascular disease tense thirst and hunger, weight is much higher for a diabetic, it is crugain, unusual weight loss, fatigue, cial that blood pressure and cholescuts and bruises that do not heal, male sexual dysfunction, numbness terol levels are monitored regularly. • As smoking might have a serious and tingling in hands and feet. • if you have Type 1 and follow a effect on cardiovascular health, diahealthy eating plan, do adequate ex- betics should stop smoking. ercise, and take insulin, you can • Hypoglycemia - low blood glucose - can have a bad effect on the palead a normal life. • Type 2 patients need to eat tient. Hyperglycemia - when blood healthily, be physically active, and glucose is too high - can also have a test their blood glucose. They may bad effect on the patient. • The most common diabetes symp-
DR SUDHA PRASAD Professor & IVF Coordinator Maulana Azad Medical College, New Delhi, India
Causes, Complications & Prevention
DIABETES Diabetes mellitus (DM) is one of the world's major diseases. It currently affects an estimated 143 million individuals worldwide and this number is growing rapidly. It is also a big challenge for India and is potentially becoming epidemic. In India, about 5% of the population suffers from diabetes.
What is prediabetes? The vast majority of patients with type 2 diabetes initially had prediabetes. Their blood glucose levels where higher than normal, but not high enough to merit a diabetes diagnosis. The cells in the body are becoming resistant to insulin. Studies have indicated that even at the prediabetes stage, some damage to the circulatory system and the heart may already have occurred. nation, increased hunger, feeling tired all the time, blurred vision, numbness or tingling in the feet or hands, sores that do not heal easily and unexplained weight loss. People with diabetes tend to develop heart disease at a younger age than people without diabetes. In adults with diabetes, the most common causes of death are heart disease and stroke. This is because over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease. Diabetes can damage the nervous system too resulting in diabetic neuropathy. It can lead to problems with your heart rate and blood pressure, digestive system, bladder, sex organs, sweat glands, and eyes. It can also cause loss in sensation in feet resulting in sores which aren’t noticed and can result in ulcers. It can cause damage to your eyes that can lead to poor vision or even blindness. The retina is the inner lining at the back of each eye. The retina senses light and them energy. So, Insulin help utilize the glucose we eat. turns it into signals that your brain decodes, so you can see the world around you. Damaged blood vessels can In DM, over time, having too much glucose in your blood can cause serious problems. It can damage your harm the retina and cause production of abnormal blood vessels, causing a disease called diabetic eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even due to poor or no blood retinopathy.These abnormal new blood vessels can lead to serious vision problems. The part of your retina supply, the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes, which that you need for reading, driving, and seeing faces is called the macula. Diabetes can lead to swelling in the can affect both the mother and the child. Symptoms of type 2 diabetes often develop slowly, usu- macula, which is called diabetic macular edema. Over time, this disease can destroy the sharp vision in this ally over the course of several years. They can be so part of the eye, leading to partial vision loss or blindmild that you might not even notice them. Because of their indolent course, some people do not find out they ness. Other eye problems caused by diabetes include; have the disease until they have diabetes-related health early cataract and glaucoma. Diabetes is a leading cause of kidney disease. The main problems, such as blurred vision or heart disease. Symptoms of diabetes include; increased thirst and uri- job of the kidneys is to filter body wastes and extra
type 2 diabetes The body does not produce enough type 1 diabetes insulin for proper function, or the cells The body does not produce insulin. Some people may refer to this type as in the body do not react to insulin (insulin resistance). Approximately 90% insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. Peo- of all cases of diabetes worldwide are type 2. Some people may be able to ple usually develop type 1 diabetes control their type 2 diabetes sympbefore their 40th year, often in early toms by losing weight, following a adulthood or teenage years. healthy diet, doing plenty of exercise, Type 1 diabetes is nowhere near as common as type 2 diabetes. Approxi- and monitoring their blood glucose levels. However, type 2 diabetes is mately 10% of all diabetes cases are typically a progressive disease - it type 1. Patients with type 1 diabetes will need to take insulin injections for gradually gets worse - and the patient will probably end up have to take inthe rest of their life. They must also ensure proper blood-glucose levels by sulin, usually in tablet form. gestational diabetes carrying out regular blood tests and This type aects females during pregfollowing a special diet.
tYPes of Diabetes
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nancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose. Diagnosis of gestational diabetes is made during pregnancy. The majority of gestational diabetes patients can control their diabetes with exercise and diet. Between 10% to 20% of them will need to take some kind of blood-glucose-controlling medications. Undiagnosed or uncontrolled gestational diabetes can raise the risk of complications during childbirth.
depression, anxiety and some other mental disorders • hearing loss - diabetes patients have • eye complications - glaucoma, a higher risk of developing hearing cataracts, diabetic retinopathy, and problems some others. • gum disease - there is a much • foot complications - neuropathy, ulhigher prevalence of gum disease cers, and sometimes gangrene which among diabetes patients may lead to foot amputation • gastroparesis - the muscles of the • skin complications - people with distomach stop working properly abetes are more susceptible to skin • ketoacidosis - a combination of keinfections and skin disorders tosis and acidosis; accumulation of ke• heart problems - such as ischemic tone bodies and acidity in the blood. heart disease, when the blood supply • neuropathy - diabetic neuropathy is to the heart muscle is diminished a type of nerve damage which can • hypertension - common in people lead to several different problems. with diabetes, which can raise the risk • hhns (hyperosmolar hyperof kidney disease, eye problems, heart glycemic nonketotic syndrome) attack and stroke blood glucose levels shoot up too • mental health - uncontrolled diahigh, and there are no ketones presbetes raises the risk of suffering from
comPlications linkeD to uncontrolleD Diabetes
ent in the blood or urine. it is an emergency condition. • nephropathy - uncontrolled blood pressure can lead to kidney disease • PaD (peripheral arterial disease) symptoms may include pain in the leg, tingling and sometimes problems walking properly • stroke - if blood pressure, cholesterol levels, and blood glucose levels are not controlled, the risk of stroke increases significantly • erectile dysfunction - male impotence. • infections - people with badly controlled diabetes are much more susceptible to infections • healing of wounds - cuts and lesions take much longer to heal
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water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. Over a period, damaged kidneys can result in hypertension and kidney failure. Sexual and urologic complications occur because of damage caused to blood vessels and nerves. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. Urinary tract infections and bladder problems occur more often in people with diabetes. If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. These changes will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. Changes such as exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your blood glucose level and take medicine if prescribed. Diabetes can be controlled and managed to prevent complications. Controlling weight is an important part of preventing diabetes. And once you lose the weight, it
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is important that you don't gain it back. This would involve: • Following a healthy eating plan. It is important to reduce the number of calories you eat and drink each day, so you can lose weight. The diet should include variety of foods from each food group, including plenty of whole grains, fruits, and vegetables, smaller portions and less fat and sugar. It's also a good idea to limit red meat and avoid processed meats. • Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit. Along with following your diabetes care plan, you may need diabetes medicines, which may include pills or insulin injections. Over time, you may need more than one diabetes medicine to manage your blood glucose. Even if you don’t take insulin, you may need it at special
times, such as during pregnancy or if you are in the hospital. You also may need medicines for high blood pressure, high cholesterol, or other conditions. Various blood tests can show if you have diabetes. Another a very specific test, the HbA1C, can also check on how you have managed your diabetes over the last three months. Some people, especially who are on insulin require regular glucose monitoring. Too low (<70 ng/dl) blood glucose is also very dangerous. This is known as severe
hypoglycemia. Symptoms tend to come on quickly and include light-headedness, disorientation, blurred vision, headache and lots of sweating. Blood glucose level may become so low that you may fall unconscious. This condition is more common in people with type 1 diabetes. If you begin to feel one or more hypoglycemic symptoms, check your blood glucose. If your blood glucose level is below your target or less than 70, eat or drink something sugary immediately.
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I
n general infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Many physical & emotional factors can cause infertility. It many result from an issue with either you or your partner, or a combination of factors that interfere with pregnancy. The most common cause of female infertility is lack of or irregular ovulation. In premature ovarian failure the ovaries stop functioning before natural menopause. In Polycystic Ovarian Syndrome (PCOS) the ovaries may not release an egg regularly or they may not release a healthy egg. PCOS (Polycystic Ovarian Syndrome) is one of the most common Endocrine Disorder in women of reproductive age. Its prevalence may reach up to 18% of women of reproductive age. It usually presents with irregular menstrual cycles, signs of hyper androgenism &insulin resistance. Patients with PCOS are at increased risk of developing reproductive, metabolic & cardiovascular disorders, including infertility, insulin resistance, DM type II, hypertension &
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atherosclerosis. Moreover it may affect daily physical activities. The classic triad of this syndrome consists of chromic anovulation, hirsutism and obesity. If untreated it can cause rise in TSH level & insulin resistance. PCOS in usually diagnosed clinically in women who present with scanty menstruation, unwanted hair on body, acne, obesity after excluding other hormonal disorders. However, most women with PCOS do not exhibit all of these features and there is a considerable controversy about required criteria for the diagnosis. It's diagnosis can be established by USG. Early diagnosis and treatment of PCOS reduces chances of infertility in women, but if untreated/maltreated the patient may remain infertile until proper treatment. PCOS is primarily a clinical diagnosis, and laboratory findings should only be used to support the clinical testing and rule out other serious disorders. Longevity of a case may make it complicated as we have discussed above, it affect other body hormones as well.
PCOS
& infertility DR SIMI SOOD Infertility & Reproductive Medicine Specialist at Neelkanth Fertility & Womenâ&#x20AC;&#x2122;s Care Hospital, Udaipur.
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[
[
research on Pcos
Some current studies focus on: • Genetics and PCOS • Environmental exposure & PCOS • Ethnic and racial differences in PCOS symptoms • Medicines and supplements to restart ovulation • Obesity and its link to PCOS • Health risks for children of women with PCOS
sYmPtoms of Pcos
• irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods. • Too much hair on the face, chin, or parts of the body where men usually have hair. This is called "hirsutism." Hirsutism affects up to 70% of women with PCOS. • Acne on the face, chest, and upper back • Thinning hair or hair loss on the scalp; male-pattern baldness • Weight gain or difficulty losing weight • Darkening of skin, particularly along neck creases, in the groin, and underneath breasts • Skin tags, which are small excess flaps of skin in the armpits or neck area
associateD health risks There are several health risks associated with PCOS. These include: • type 2 diabetes • infertility • high cholesterol • elevated lipids • sleep apnea • liver disease • abnormal uterine bleeding • high blood pressure • obesity possibly leading to issues with low self-esteem and depression • metabolic syndrome • nonalcoholic fatty liver (steatohepatitis) • depression and anxiety • endometrial cancer • gestational diabetes • pregnancy-induced high blood pressure • heart attacks • miscarriage.
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Sometimes we see patients come to us for infertility diagnosed with PCOS. So before starting treatment, infertility evaluation should include measurement of Thyroid Stimulating Hormone (TSH), prolactin. Insulin resistance can best be evaluated by a 2 hour glucose tolerance test (TTT) In HgbA1C. Apart from all above diagnosis, low birth weight babies, large for gestational age girls born to overweight mothers, obesity syndromes, insulin resistant features are all risk factors for development of PCOS. These tests are to be performed for initial diagnosis and every two years thereafter depending on risk factors and life style changes. Lifestyle & dietary modifications may help in management of PCOS to a certain level. Further management of PCOS aims to lower body weight & insulin levels, restore fertility, treat hirsutism or acne, restore regular menstruation and prevent complications. Weight reduction, diet & exercise are recommended for all women with PCOS where PCOS is associated with overweight or obesity. Successful weight reduction is the most effective method of restoring normal ovulation & menstruation. Some studies have also shown a 510% loss in body weight, may result in a return of ovulatory cycles and a higher spontaneous pregnancy rate. Low carbohydrate diet and sustained regular exercise may help. Another option for these women is to use low dose oral contraceptive pills (OCP’S) to regulate menstrual cycle and provide contraception. In patients desiring pregnancy, ovulation induction in often required usually with clomiphene citrate. Insulin resistance has been implicated in the reproductive consequences of PCOS, namely infertility, miscarriage and gestational diabetes. Reducing insulin sensitivity through medications seemed to show effectiveness in lowering insulin and blood sugar levels in women with PCOS. Assisted reproductive technology procedures such as controlled ovar-
ian hyper- stimulation with FSH injection followed by in vitro-fertilization (IVF) are used for patients who do not respond to clomiphene, diet and life style modifications. Though surgery is not commonly performed, the polycystic ovaries can be treated with a laparoscopic procedure with bilateral ovarian diathermy involves “drilling” in the ovary, which often results in either resumption of spontaneous ovulation or ovulation after adjuvant treatment. Offering psycho-social support to the female can be one of the most important aspect of managing PCOS depression. Early diagnosis & intervention of PCOS is important to treat symptoms and prevent long term consequences. There is no thumb rule in the treatment of infertility associated PCOS. It needs a combination of clinical expertise with use of Advance Reproductive Treatments.
healthY Pcos Diet
• natural, unprocessed foods • high-fiber foods • fatty fish, including salmon, tuna, sardines, and mackerel • kale, spinach, and other dark, leafy greens • dark red fruits, such as red grapes, blueberries, blackberries, and cherries • broccoli and cauliflower • dried beans, lentils, and other legumes • healthful fats, such as olive oil, as well as avocados and coconuts nuts, including pine nuts, walnuts, almonds, and pistachios • dark chocolate in moderation • spices, such as turmeric and cinnamon
PCOS & homeopathy
6
A SILENT DISORDER Polycystic Ovarian Syndrome (PCOS), is called a ‘Silent Disorder’, because 1 in every 4 women suffers from PCOS and yet half of these women go undiagnosed. The reason why this hormonal disorder, that affects over 10 million women globally, goes undiagnosed is because it doesn’t cause pain in most cases. Unfortunately, many women seek medical assistance only when pain starts affecting their routine life. They often neglect the other important PCOS symptoms like mood swings, anxiety, uncontrolled weight gain, increased acne, irregular periods and unwanted hair growth on face. This ignorance often leads to several health complications later including infertility.
sister has about a 40% chance of having it as well. Stress may be both a symptom and a possible cause of PCOS. Insulin resistance and PCOS are linked as well. However, what’s not known is if insulin resistance causes PCOS or if PCOS leads to insulin resistance.
HOMEOPATHY EFFECTIVELY TREATS PCOS The conventional treatment for PCOS focuses on treating its visible and most troublesome symptoms. Medicines offered treat irregular periods, acne, excess hair, and elevated blood sugar. However, the root cause, which is hormonal imbalance, is left untreated. Homeopathy focuses on this root cause. Homeopathic remedies work on correcting the hormonal imbalance, regularizing ovulation as well as restoring menstrual normalcy. It also FACTORS THAT PUT YOU AT RISK OF helps treat the associated symptoms of PCOS GETTING PCOS effectively. The primary risk factor for PCOS is family history. There is a higher chance of developing Also, long-term medicines that are conventionally recommended to suppress the cysts formaPCOS if your mother or other women in your family have a history of irregular periods or di- tion could lead to side-effects like abetes. If a woman is diagnosed with PCOS, her cervical/uterine cancer. Homeopathy treats
DR MUKESH BATRA Padma Shri recipient and Founder & Chairman Emeritus, Dr Batra’s Group of Companies
HE & SHE
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case stuDY
A couple came to us for infertility treatment and the wife was diagnosed with PCOS. She complained feeling indolent, and had a tendency to put on weight. Besides, her monthly periods were regularly irregular. We gave her the homeopathic remedy Thuja Occidentalis 200C and recommended her ultrasonography (USG) after eight months. Not only did her monthly periods become regular, but within the 8 months timeline, her USG reports too revealed no abnormality, or any presence of the cysts. it did not take long, thereafter, for the couple to visit us with a positive pregnancy test report.
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PCOS effectively with no side-effects. Moreover, homeopathy is an individualised treatment, which means, that no two women would be recommended the same medication despite presenting similar symptoms. Homeopathy does not recommend a one-suit-fits-all approach; each woman is given different medication, which is specific to her and effectively addresses the root cause of the ailment. Stress management, weight control, corrective lifestyle habits along with the medicines can be of considerable help. While the hormonal imbalances can be kept in check, homeopathy can also help to treat infertility in women who are planning for a pregnancy.
Phosphorus, Silicea, Sulphur, Calcariasulph, Borax, Hepar- sulph, Kali-brom • Infertility: Pulsatilla, sepia, terantula, apis, lycopodium, lachesis (Please do not self-medicate. Consult a homeopath for an appropriate dosage and duration of treatment).
SELF-CARE TIPS In addition to medication, here are some self-care tips to deal with PCOS: • Exercise: It helps reduce excess fat. Excess fat can produce more estrogen, which leads to hormonal imbalances. Even reducing just 5-10% of body weight will help ease the symptoms and regularize menstrual cycle • Diet: Avoid processed sugar and white flour. Eat a balanced diet of healthy fats, Some homeopathic remedies for treating protein, green vegetables, grains, nuts, seeds and legumes. PCOS & associated complaints are: • Avoid alcohol and smoking: Smoking • Hair loss & PCOS: Weisbaden, Arnica, and alcohol can cause hormonal imbalThuja, Acid flour, China • Acne & PCOS: Berberis aquafolium, ance which could make PCOS worse.
Womenâ&#x20AC;&#x2122;s Health
DR PRASHANT NYATI Consultant Gynecological & Robotic Onco-Surgeon, SL. Raheja Hospital, Mumbai
OVARIAN CANCER Symptom, Causes & Treatment
Women’s Health
C
Early symptoms • Abnormal fullness after eating (early satiety) and indigestion • Increased frequency of urination • Fatigue • Frequent acidity • Pain in the back and legs • Irregular periods • Painful intercourse
ancer is normal cells of our body behaving abnormally, loose control on the cell division and cell death. These unrestricted cell division form Lump (Tumour) which can be Benign (does not spread to other parts of body) or Malignant (can spread to other parts of body). The female reproductive organs consist of Uterus, Fallopian Tubes, Ovaries, Cervix, and Vagina. The Ovaries are two in number and are situated on either side of the Uterus. The ovaries have a very important function of producing Egg (Ova) along with female hormones; Ovarian size varies as per age. The occurrence of Ovarian Cancer varies with demography and location in India, and ranges roughly at 8.4 per 1,00,000 women population. The age of diagnosis reaches peak between 55-64 years, but now-a-days we are seeing it in younger women between the age group of 30-35 years. Roughly, only about 10-20% of Ovarian Cancer are diagnosed in early stage. Since the Ovaries are situated in the abdominal cavity, the signs and symptoms are very vague and are masked by common day to day problems and complaints. Also, women have high level of tolerance, hence smaller problems are overlooked till they grow in magnitude. Know yourself and beware of changes in your body habit, if symptoms persist for longer durations, consult an expert.
Ovaries consist of 3 types of cells, and each cell lining can develop in a different type of Ovarian Cancer. • Epithelial Tumors form 90% of Ovarian Cancers,they arise from the layer of tissue on the outer surface of the ovaries • Stromal Tumors grow in the hormone-producing cells • Germ Cell Tumors develop in ovarian cells that produce eggs There is one type of Ovarian Cancer, which is in between the ‘malignancy and benign’ stage, known as ‘Borderline Ovarian Cancer’, with low malignant potential, is less aggressive in nature and has limited spread. DIAGNOSIS: It is much easier to treat Ovarian Cancer if diagnosed it in the early stages, but as the Ovaries are situated in pelvic region of the abdominal cavity, and the abdomen has large capacity to accommodate, hence even large size tumors go unnoticed for long time. There’s no standard diagnostic screening available for Ovarian Cancer, other than Ca125, which is not very accurate. This draws even more importance towards identification of persistent symptoms and seeking expert opinion. Detailed physical examination is followed by laboratory test and imaging studies such as: • Ultrasonography, CT scan, MRI abdomen & pelvis, 3PET Scan
Risk factors for Ovarian Cancer The exact cause of Ovarian Cancer is not known, but we know certain factors that can increase the risk: • Genetic Mutation of genes associated with Ovarian Cancer, such as BRCA1 or BRCA2 • Personal or family history of Breast Cancer • The use of certain fertility drugs or hormones for longer then recommended duration • Nulliparity (not being able to get pregnant) • Obesity
• Tumor marker levels: Ca125, CEA, Ca19.9. AFP, BhCG, HE4 • Upper and lower GI scopy • These are biomarker and proteins that are used to assess treatment response and recurrence for Ovarian Cancer, and other reproductive organ Cancer • Biopsy: This involves removing a small sample of tissue from the Ovaries or abdominal metastasis and analyzing the sample under a microscope, to confirm the diagnosis.
Radical Staging Surgery for Ovarian Cancer normally includes: • Pan Hysterectomy with removal of bilateral Fallopian Tubes and Ovarian masses • Pelvic and Para Aortic Lymph Nodes dissection • Omentectomy (procedure designed to remove the omentum) • Metastatic Tumor excision including Splenectomy, Gallbladder removal and Liver resection • SOS Appendicectomy, Peritonectomy and Sub-Diaphragmatic resection STAGING OF OVARIAN CANCER: • Resection and Anastomoses of intestines There are four stages in all, and each stage These are routinely conducted major surgerhas sub-stage: ies, which requires 4-6 days of hospitalisa• Stage 1: Limited to one or both ovaries tion and certain pre-operative preparation. • Stage 2: Limited to the pelvis With advances in technology, we are able to • Stage 3: Disease outside of the pelvis, but perform some of the surgeries for Ovarian limited to the abdomen, or Lymph Nodein- Cancer Laparoscopically or Robotics asvolvement, but not including the inside of sisted.This leaves practically no scars, enthe Liver ables lesser hospital stay, faster return to • Stage 4: Disease spread to the Liver or out- routine activities and better quality of a life. side of the abdomen But,this is applicable to selective few cases, which have very limited diseases and low TREATMENT OF OVARIAN CANCER: grade. Different techniques of surgery Ovarian Cancer is to be treated by multiknown as HIPEC and IP Chemotherapy are modal approach including Surgery, also used in select cases with its due risks. Chemotherapy, Radiation, Hormones therBefore the surgery,the treatment plan is disapy, targeted drugs, along with Psychologicussed with the patient and immediate famcal Counselling, which us of utmost ily members, the effects and side effects, risk importance. The management depends on and complications are discussed and exthe stage(spread) and grade of the Cancer, plained in detail. Also, if needed Psychosexand now-a-days age of patient, as we see ual or Psychological Counselling should be many younger girls where future fertility is offered. at risk. The team of doctors including MedChemotherapy: There are various types of ical and Surgical Oncologist will plan appro- Chemotherapy drugs available which are priate treatment depending on your state. normally used in combination for treating Surgery: Primary Staging Surgery can be Ovarian Cancer. Either the Chemotherapy done if the probability of complete recan be given prior to surgery as Neoadjumoval is possible or else 2-4 cycles of vant, or after surgery as Adjuvant Therapy. Chemotherapy (Neo-adjuvant) is given, There are various effects and side effects of followed by Interval Debulking Cytoreduc- the chemotherapeutic agents ranging from tive surgery. Depending on type, grade nausea, vomiting, to fall in total Leukocyte and stage of Ovarian Cancer, the type of count. But with advances in technology, we surgery (Radical or Conservative) is deare able to tide over the adverse reactions cided by the Gynaecological Onco-surgeon and give a better quality of life to our paand his team. In case of Germ Cell Tumour, tients. Chemotherapy can be administered Sex Cord Stromal Tumour, Borderline in day-care setup, so the patient is out of Ovarian Cancer and Stage I Epithelial hospital in few hours and can do go back to Ovarian Tumor, conservative surgery is normal routine activities. possible in selected cases,so as to retain Targeted Therapy: Targeted Therapy attacks fertility and hence future chances of preg- the Cancer cells while doing little damage to nancy. This is known as ‘fertility sparing normal cells in the body. surgery’ where only the diseased Ovary is Radiation: In Ovarian Cancer only few seremoved along with proper staging, and lected cases require Radiation Therapy uterus & the other Ovary is conserved.
Fertility preservation In case of conservative treatment of young patients, there can be some harm to the reproductive organs and hence make future pregnancy difficult. In such cases, well trained Councellors, Medical Oncologists, Surgical Oncologists and Fertility Specialists, come together with the patient and their family to discuss options for preserving fertility with following options: • Embryo Freezing: Here the fertilized egg is frozen • Oocyte Freezing: Here the unfertilized egg is frozen • Surgery to preserve fertility: In some cases, surgery that only removes one ovary and keeps the healthy ovary can be done. This is usually only possible in early stage Ovarian Cancer • Ovarian tissue preservation: This involves removing and freezing ovarian tissue for future use. • Ovarian suppression: This involves taking hormones to suppress ovarian function temporarily.
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PREVENTION There is no definitive way to prevent Ovarian Cancer, but certain steps can help us to prevent, and have an early diagnosis, for better survival and excellent quality of life: • Judicious use of oral birth contraceptive pills • Breastfeeding the baby • Having pregnancy • Healthy lifestyle with good exercise In case of family history of Ovarian, Breast, or Intestinal cancer in close family members, you must meet a doctor. We recommend following plan of action for early diagnosis: • Ultrasonography (Transvaginal), once or twice weekly after 35 years of age • Ca-125 • Clinical examination by expert • Genetic Counselling and Gene Study such as
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BRCA 1 & 2 and risk reduction surgery in genetic tested high-risk group. Consult Gynaecological Onco-surgeon if following symptoms last for 2-4 weeks: • In case of sudden change in bowel or bladder habits • Changes in menstrual cycle • Early satiety • Abdominal distension, fullness, bloating SURVIVAL Survival depends on the stage and grade of the Ovarian Cancer. Early stage at time of detection, improves chances of survival and quality of life. Once the treatment is complete, the person has to be on recommend following-up schedule, as advised by the Gynaecological Onco-Surgeon.
Health Tips drink 8 glasses of Water a day No need to count cups. Research shows people who gulp a glass of H2O when they’re thirsty get enough to stay healthy and hydrated. You might need to drink more water if your urine is dark yellow, you don’t go regularly, you're very active, or you live in a hot climate.
eggs are Bad for your heart Eating an egg or two a day doesn’t raise the risk of heart disease in healthy people. Yes, the yolks have cholesterol, but for most of us, the amount found in any one food isn’t as bad for you as the mix of fats from everything you eat. What’s more, eggs have nutrients, like omega-3s, that may lower the risk of heart disease.
antiperspirant Causes Breast CanCer Don’t sweat it! Some scientists think the chemicals found in antiperspirants and deodorants can be absorbed through your underarm. The idea is they end up in breast tissue and make tumors more likely. But the National Cancer Institute says there’s no evidence connecting either product with breast cancer.
Being Cold gives you a Cold No matter what your grandma might've told you, spending too much time in the cold air doesn’t make you sick. One study found that healthy men who spent several hours in temperatures just above freezing had an increase in healthy, virus-fighting activity in their immune systems. In fact, you’re more likely to get sick indoors, where germs are easily passed.
eat Breakfast to lose Weight Eating breakfast does help some people lose weight. It can stave off hunger, and it might prevent random eating later in the day. If you’re not a breakfast fan, you can still slim down. A Cornell University study found that the nonbreakfast crowd didn’t overeat at lunch and dinner, and they ate about 400 fewer calories a day. The bottom line: Skipping breakfast may help some healthy people shed pounds.
green MuCus Means infeCtion The contents of your tissue can’t take the place of a lab test. Studies show that green or yellow mucus is slightly more common in certain bacterial infections. But it’s not a sure sign that you have one or that you need antibiotics. A sinus infection can cause clear mucus, and a common cold can turn it green. sugar Makes kids hyper Sugar isn’t good for kids, but research shows the sweet stuff won’t cause them to act out, hurt their schoolwork, or make them unable to focus.
HEALTH MYTHS Debunked
CraCking Joints Causes arthritis The sound might annoy people around you, but that’s about all the harm it does. You may think bones or joints rub together to cause the noise, but that’s not so. It results from a gas bubble that forms between the bones and “pops.” If you enjoy doing it, keep on. Studies show it doesn’t cause or play a role in arthritis. If you feel regular or severe pain when you do it, see your doctor.
you need a daily MultivitaMin You may have heard that a multivitamin can make up for nutrients that aren't in your diet. Researchers don’t all agree on that point. But if your doctor tells you to take vitamin, do it. And if you’re pregnant, you need to take folic acid to lower the risk of birth defects.
a toilet seat Can Make you siCk Don’t stress if you can’t cover the seat. Toilet seats are usually pretty clean - it’s bathroom doors, door handles, and floors that tend to be covered with bugs like E. coli, norovirus (a.k.a. “stomach flu”), and the flu. Cover your hand with a paper towel before you touch doors or handles, and use hand sanitizer or wash afterward.
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Fertility Tips
DR RUPAL N. SHAH Infertility & ART consultant and Medical Director of Blossom Fertility & IVF Centre, Rupal Hospital for Women & Vama Wellness Centre for Women, Surat.
Obesity is a known risk factor for ovulation problems, but it also contributes to infertility in women who ovulate normally. Research shows that excess weight can reduce your chances of becoming pregnant. Obesity has a number of adverse effects on a woman or man’s fertility.
Obesity & Infertility WHAT IS OBESITY? Obesity is defined as excess adipose tissue (fat). There are several different methods for determining excess adipose (fat) tissue; the most common being the Body Mass Index (BMI) . BMI is calculated by dividing a person's body weight in kilograms by their height in meters squared. The BMI cutoffs are: Below 18.5 Underweight 18.5-24.9 Normal weight 24.5-29.9 Overweight 30 and greater Obese 40 and greater Morbid or extreme obesity If BMI is above 30, capacity of conception in female decreases . According to one research,a woman with a BMI of 35 was found to be 26% less likely to achieve a spontaneous pregnancy than women who were normal weight or overweight but not obese. A woman with a BMI of 40 or more was 43% less likely to get pregnant. HOW OBESITY AFFECTS FERTILITY? 1. Obesity affects your hormones When your body mass index goes past the overweight category (BMI of 25–29.9) into the obese category (BMI of 30 and above), hormonal changes may occur in your body. When your levels of natural hormones change, your chances of conception decrease.
2. Obesity leads to insulin resistance The hormonal imbalance that comes with obesity often leads to insulin resistance. That is a major risk factor on the road to diabetes - but it also affects your fertility and can create abnormal menstrual cycles. Insulin resistance can lead to anovulation, in which your body does not produce eggs properly. 3. Obesity affects natural and assisted pregnancies Obesity makes it more challenging to become pregnant, no matter whether you’re using natural means or by reproductive technologies such as in vitro fertilization (IVF). It also increases your risk for a miscarriage. This issue may be caused by the hormonal issues or because of your body is producing poor quality eggs. 4. Obesity decreases your partner’s fertility, too Although much of the focus on obesity and infertility is on women, it absolutely affects men too. For men, obesity leads to a drop in testosterone hormone level which can lead to infertility. On top of that, erectile dysfunction occurs at a higher rate among obese men. Most of the time obesity is associated with hormonal disturbances in infertile women, in the form of Polycystic ovaries associated with anovulation, other pitutary or thyroid gland dysfunction or it can be due to genetic problems or problems
related to unhealthy life style and eating habits. HOW TO COPE WITH THIS PROBLEM? When you visit a doctor, in the first visit, doctor will advise you to reduce your weight. And you start dieting, and exercise immediately, but this will not give any magical result in a short time. Sometimes because of crash dieting also there are severe hormonal disturbances leading to anovulation, worsening your infertility problem. Sometimes, weight is reduced, but it will not help your infertility problem. To keep your ovary fit, add healthy food in your
which are easily available from green vegetables, fish, eggs, full grains, and cereals. Zinc and Chromium effectively improve pimples and wrinkles over the skin. • Vitamin B12 is available from Fresh Curd, Paneer, Sprouted Beans and fermented food items like dosa, idli, dhokla etc. • In problems like PCO, requirement of calcium increases. Have more calcium content in your diet. Food like chocolate, cakes, sweets, processed food, aerated drinks reduce calcium and chromium in the body. This effectively reduces insulin production and increases fats. So please avoid such items in your diet. • You may take tablets of Vitamin A, E, D, and B12 and Calcium in your diet supplement. EXERCISE Regular exercise is a key for regular menstrual cycle. And regular menstrual cycle means regular ovulation and increase in chances of pregnancies. It is necessary that to reduce your weight, exercise is equally important as your diet. Over enthusiastics do excess exercises, but it is not necessary. Regularity in exercise is important. • 30 - 40 minutes aerobic exercise per day for 3 to 5 days in the form of walking, jogging, cycling, swimming, dancing will also help you to keep your goals. • To balance your weight, at least twice a week practice muscle strengthening exercises. This is done with dumbbells, or using various machines in a gym. • You can do yoga at least 10 to 15 minutes per day, which will include muscle stretching in your diet: exercise schedule. Meditation may also be in• Eat fresh food (Please avoid re-cooked food). cluded into your workout plans. • Eat fruits and vegetables raw. (By making soups • To reduce your weight, contact a dietician and or juices of vegetables and fruits, the nutrients of gym/yoga trainers, who will guide you to approvegetables and fruits are destroyed). priate exercise and proper food. • Do not decrease carbohydrates in your food. But Exercise boosts up functions of almost all the eat the same without any process. Use wheat, body parts including ovaries. It will enhance injuwar or bajra by making roti, thepla, bhakri etc. sulin, which will control your sugar levels. This In place of polished rice, use red rice (Brown helps you in balancing sugar levels in your blood, Rice), so the content of fiber is high in your food. which will improve your ovulation. While trying to • Protein is required for maintenance of all horreduce your weight, it is important that you have mones in ovary. So, increase protein level in your proper sleep and a stress-free mind also. diet. Pulses, eggs, fish, paneer are rich sources of protein. Extracted from: • Wherever fat is used, use the ones containing es‘Joy of Getting Pregnant’ sential fatty acids like Omega-3, and Omega-6. by Rupal N. Shah These are available from groundnut oil, sesame oil, olive oil, dry fruits mainly from almonds and walnut. • Walnut gives you Alfa Lipoic Acid, which works like insulin which also helps to reduce fat. • Micro-nutrients like selenium, zinc, and chromium increases effectiveness of insulin,
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You’re going soft more than you care to admit
Your sex drive has been stuck in neutral
Limping into the bedroom more than twice a month may mean your heart’s just not into it: An Austrian study found that the risk of developing heart disease within 10 years was 65 percent higher in men with moderate or severe erectile dysfunction than in men without ED. Blood vessels in the penis are significantly smaller and start to narrow long before those in the heart or brain. Talk to your doc, who can refer you to a cardiologist.
If the fire is dying in bed, your partner isn’t necessarily to blame. Obstructive sleep apnea (OSA), a sleep disorder in which your airway becomes blocked, might be reducing your sex drive. German researchers found that men with the lowest levels of nighttime blood oxygen reported sexual desire levels that were 11 percent lower than men who breathed easily. OSA can reduce testosterone, affecting your erections as a result.
You see that the tip is red and swollen No, not that type of swollen. We mean inflammation, redness, and pain at the head of your smokestack. It’s called balanitis, and it’s typically caused by bacteria, viruses, or fungi, often as a result of less-than-stellar hygiene. And get checked for diabetes. Research from Bristol-Myers Squibb shows that people with diabetes are nearly three times as likely as nondiabetics to develop balanitis.
You have to urinate more often than usual The likely cause of your plumbing problem is benign prostatic hyperplasia, or BPH, a condition that rarely causes symptoms before age 40 but affects up to 90 percent of men in their 70s and 80s.
You produce less ejaculate or can’t orgasm Low testosterone could be the culprit. Testosterone helps produce semen, and the more semen you have, the more force you ejaculate with. About one-third of men who take depression medication experience difficulty reaching orgasm, according to researchers in Iran.
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Your pee has gone from yellow to red A pink bowl is a red flag. Blood can be a sign of prostate, bladder, or kidney disease, so you need to find out where the blood is coming from. On the other hand, bloody semen during sexual activity is less likely to signal deadly danger. Still, ask your doctor to check it out.
You notice it doesn’t feel as sensitive as before A numb knob could be a sign of poor diet. Each day, make sure you consume at least 2.4 micrograms of vitamin B12, from such sources as clams, milk etc, and 400 micrograms of folate, found in leafy greens and black-eyed peas. A deficiency in these vitamins can prevent nerve fibers in your penis from carrying signals to your brain. Next, have your blood sugar tested to rule out diabetes. Even a mildly high level—above 100 mg/dL after eight hours of fasting—can impact penile sensitivity.
Your erection is curving at a strange angle You might be one of the up to 23 percent of men ages 40 and over who will get Peyronie’s disease, a condition that makes an erect penis bend in any direction at an angle of 30 degrees or more. It strikes when collagen plaques form on the connective tissue surrounding the spongy interior of the penis. The cause may be genetic or a sign of too much or too little sexual activity. Seek treatment within 24 hours and consider a blood sugar test. High glucose levels alter stem cells in your penis, encouraging plaque to form.
Men’s Health
Health Issues Your ‘Manhood’ Is Indicating Believe it or not, your favorite organ can be really informative.
Mental Wellness
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DR FABIAN ALMEIDA Consultant Psychiatrist, Fortis Hospital Kalyan
Obsessive
Compulsive Disorder Symptom & Treatment
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O
bsessive-Compulsive Disorder is a form of mental illness, often ignored till secondary consequences interfere in the routine of daily life. Obsessive–Compulsive Disorder (OCD) affects about 2.3% of people at some point in their life. People with OCD can have either obsessive thoughts or ruminations leading to compulsive, repetitive behaviors, thereby putting their life into disorder. WHAT ARE THE SYMPTOMS ONE SHOULD WATCH OUT FOR? The symptoms of OCD include varying levels of Anxiety associated with thoughts that are repetitive, intrusive and seemingly not in one’s control. Thus, obsessions are thoughts, ideas or images that simply won’t go away. These thoughts are distressing and can be related to various themes like cleanliness, orderliness, symmetry, perfection, purity of thought, severe doubts, infection control, sexual, hoarding etc. These intense, incapacitating thoughts then necessitate the person to perform certain actions or behaviors compulsorily, to redeem themselves from the associated Anxiety and helplessness. The person begins to attach extraordinary significance to these thoughts, which may range from being unclear and confusing to being vivid, and meticulously detailed. For eg; a person obsessed about cleanliness and infection control, may be forced to repeatedly wash their hands and spend long hours at bathing, in an effort to wash themselves scrupulously clean. A person obsessed with symmetry and orderliness, may procrastinate long hours attempting to balance out things to perfection, following a particular matrix of colors, numbers, shape or designs. The person could be obsessed with numbers or rituals, and hence would feel the need to perform various actions for a fixed number of times or in a particular ritualistic manner, failing which, his anxiety would peak and cause further problems. A person obsessed with keeping and maintaining records could end up hoarding bills, acknowledgements etc. over many years. The OCD patient often realizes the futility of his thoughts and actions, but feels completely helpless and hopeless, about the situation. Compulsions may offer some relief, but only for a little while, eventually increasing the complexity of the illness over time. Remember, habits tend to bring efficiency to one's life, while compulsions tend to disrupt it and bring about disorder. Excessive skin picking, hair-pulling, nail biting, are all on the obsessive–compulsive spectrum. They display many signs of depression, excessive worry, extreme tension, and the constant feeling that nothing is ever right- these symptoms worsen over time, and can lead to suicidal thoughts too.
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It is important to note that these obsessions or compulsions must be time-consuming (taking up more than one hour per day) or cause impairment in social, occupational or scholastic functioning. It is helpful to quantify the severity of symptoms and impairment before, during and after treatmentevaluating the patient’s Mental Status Examination (MSE), their own personal review and use of rating scales, such as the Yale–Brown Obsessive Compulsive Scale (Y-BOCS). From the observation of the effectiveness of antidepressants in OCD, a serotonin hypothesis of OCD has been formulated. It is also evident that OCD can be triggered increasing levels of stress- for example: a personal crisis, abuse, or something negative that affects the person a lot, like the death of a loved one. It’s more likely if people in that family have OCD or any another mental health disorder, such as Depression or Anxiety, indicating the genetic factor in transmission of the illness. Functional neuroimaging during symptom provocation has observed abnormal activity in the Orbitofrontal Cortex, left Dorsolateral Prefrontal Cortex, right Premotor clCortex, left Superior Temporal Gyrus, Globus Pallidus Externus, Hippocampus and right Uncus. OCD symptoms frequently co-occur with Schizophrenia, Bipolar Disorder and major depressive disorder. TREATMENT A combination of Cognitive Behavioral Therapy (CBT) and Psychotropic Medications serves as the best line of treatment for OCD. CBT works on the distorted cognitions of the patient, empowering them to understand how they can learn to ignore certain impulses and thereby abort the need for compulsive behaviors. One aspect of CBT- the exposure and response prevention teaches the patient to tolerate the discomfort and anxiety associated with not performing the ritualistic behaviors. Serotonin Specific Re-uptake Inhibitors (SSRI’s) form the main chunk of the effective medication for OCD. Clomipramine, a medication belonging to the class of Tricyclic Antidepressants, appears to work as well as SSRIs but has a higher rate of side effects. Associated symptoms like restlessness, Insomnia, Panic, depressive thoughts and others mandate specific treatment as per their intensity. Insight Oriented Therapies aim at helping the individual realize that their obsessions or compulsions are unreasonable or excessive. In severe cases brain surgery options have been explored, but the surgery has significant risks. A recent surgical procedure for OCD, called Deep Brain Stimulation, involves implanting a device that sends electrical impulses into the brain. Unlike the Capsulotomy Surgery, Deep Brain stimulation is reversible, and does not permanently damage tissue.
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Does It Help You Sleep? Alcohol’s slow-down effect on your brain can make you drowsy, so you may doze off more easily. But you won’t sleep well. Your body processes alcohol throughout the night. Once the effects wear off, it leaves you tossing and turning. And you’re more likely to have nightmares, vivid dreams and more trips to the bathroom.
leads to liver disease Your liver breaks down almost all the alcohol you drink. In the process, it handles a lot of toxins. Over time, heavy drinking makes the organ fatty and lets thicker, fibrous tissue build up. That limits blood flow, so liver cells don’t get what they need to survive. As they die off, the liver gets scars and stops working as well, a disease called cirrhosis.
thin Bones, less MusCle Heavy drinking can throw off your calcium levels. Along with the hormone changes that alcohol triggers, that can keep your body from building new bone. They get thinner and more fragile and may lead to osteoporosis.
a Weaker iMMune systeM You might not link a cold with a night of drinking, but there might be a connection. Alcohol puts the brakes on your immune system.
straight to your head Thirty seconds after your first sip, alcohol races into your brain. It slows down the chemicals and pathways that your brain cells use to send messages. That alters your mood, slows your reflexes, and throws off your balance. You also can’t think straight, which you may not recall later, because you’ll struggle to store things in long-term memory. Too much alcohol can actually shrink your brain.
An Offbeat Heart One night of binge drinking can jumble the electrical signals that keep your heart’s rhythm steady. If you do it for years, you can make those changes permanent. And, alcohol can literally wear your heart out.
Why you have to pee … again Your brain gives off a hormone that keeps your kidneys from making too much urine. But when alcohol swings into action, it tells your brain to hold off. That means you have to go more often, which can leave you dehydrated.
More stoMaCh aCid Booze irritates the lining of your stomach and makes your digestive juices flow. When enough acid and alcohol build up, you get nauseated and you may throw up. Your small intestine and colon get irritated, too and can lead to diarrhea.
horMone havoC To keep it all going smoothly, you need them in the right balance. But alcohol throws them out of whack. In women, that can knock your periods off cycle and cause problems getting pregnant. In men, it can mean trouble getting an erection, a lower sperm count, shrinking testicles, and breast growth.
HOW ALCOHOL AFFECTS YOUR BODY
Sexual Problems in Men DR RUPIN SHAH
Consultant Andrologist/Urologist and the first urologist from India to train abroad in andrological microsurgery & has developed India's first penile prosthesis. He is a consultant at Lilavati Hospital, Mumbai, Fakih IVF, Dubai and others.
Sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the man or couple from experiencing satisfaction from the activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor.
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FACTS • Lower cholesterol can boost performance in the bedroom • Low blood sugar can create marital discord • Post-sex cuddling can increase your satisfaction • Online ‘cures’ for ED can be dangerous • There’s a possible link between ED & your dental health
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Retrograde ejaculation is common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward. In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation. WHAT IS ERECTILE DYSFUNCTION? WHAT CAUSES MALE SEXUAL HOW DO SEXUAL PROBLEMS Also known as impotence, erecPROBLEMS? AFFECT MEN? tile dysfunction is defined as the Sexual dysfunction in men can The most common sexual prob- inability to attain and/or mainbe a result of a physical or psylems in men are ejaculation dis- tain an erection suitable for inchological problem. orders, erectile dysfunction, and tercourse. Causes of erectile • Physical causes: Many physical inhibited sexual desire. dysfunction include diseases afand medical conditions can fecting blood flow, such as athcause problems with sexual WHAT ARE EJACULATION erosclerosis (hardening of the function. These conditions inDISORDERS? arteries) due to diabetes, hyperclude diabetes, heart and vascu- There are different types of ejac- tension, and high cholesterol; lar (blood vessel) disease, ulation disorders in men: injury to pelvis and urethra; surneurological disorders, hor• Premature ejaculation: This gery for cancer of bladder or monal imbalances, chronic dis- refers to ejaculation that occurs prostate; nerve disorders; psyeases such as kidney or liver before or soon after penetration. chological factors, such as stress, failure, and alcoholism and drug • Inhibited or retarded ejacula- depression, and performance abuse. In addition, the side eftion: This is when ejaculation is anxiety(nervousness over his fects of certain medications, in- slow to occur. ability to sexually perform); and cluding some antidepressant • Retrograde ejaculation: This injury to the penis. Chronic illdrugs, can affect sexual desire occurs when, at orgasm, the ness, certain drugs, and a condiand function. ejaculate is forced back into the tion called Peyronie's disease • Psychological causes: These in- bladder rather than through the (scar tissue in the penis) also clude work-related stress and urethra and out the end of the can cause erectile dysfunction. anxiety, concern about sexual penis. Some young men may have a performance, marital or relaIn some cases, premature and primary problem with the penile tionship problems, depression, inhibited ejaculation are caused blood arteries or veins and may feelings of guilt, and the effects by psychological factors, includ- never have experienced a norof a past sexual trauma. ing a strict religious background mal erection. that causes the person to view WHO IS AFFECTED BY SEXUAL sex as sinful, a lack of attraction HOW ARE MALE SEXUAL PROBLEMS? for a partner, and past traumatic PROBLEMS DIAGNOSED? Both men and women are afevents. Premature ejaculation, To diagnose a man's sexual fected by sexual problems. Sexthe most common form of sexproblem, the doctor likely will ual problems occur in adults of ual dysfunction in men, often is begin with a thorough history of all ages. Among those comdue to nervousness over how symptoms and a physical exam. monly affected are those in the well he will perform during sex. He or she may order other tests geriatric population, which may Certain drugs, including some to rule out any medical probbe related to a decline in health antidepressants, may affect ejac- lems that may be contributing to associated with aging. ulation, as can nerve damage to the dysfunction. The doctor may the spinal cord or back.
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Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis due to diabetes, hypertension, and high cholesterol
HOW IS MALE SEXUAL DYSFUNCTION TREATED? Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following: • Medical treatment: This involves treatment of any physical problem that may be contributing to a man's sexual dysfunction. • Medications: Medications, such as sildenafil (Viagra) or
tadalafil (Cialis) will help improve erectile function in men by increasing blood flow to the penis. Dapoxetine is a drug used to treat premature ejaculation. A topical anesthetic spray containing lidocaine may also be applied to the penis reducing sensitivity and allowing for more ejaculation control. • Hormones: Men with low levels of testosterone may benefit
from testosterone replacement therapy. • Psychological therapy: Ther-
apy with a trained counselor can help a person address feelings of anxiety, fear, or guilt that may have an impact on sexual function. • Mechanical aids: Aids such as vacuum devices may help men
with erectile dysfunction. Penile prosthesis implantation is a surgical procedure that provides the final cure and can restore excellent erections even in cases of severe erectile failure. • Education & communication: Education about sex and sexual behaviors and responses may help
a man overcome his anxieties about sexual performance. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers. CAN SEXUAL PROBLEMS BE CURED? The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.
CAN SEXUAL PROBLEMS BE PREVENTED? While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function: • Follow your doctor's treatment plan for any medical/health conditions. • Limit your alcohol intake. • Quit smoking. • Exercise regularly • Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed. • Increase communication with your partner.
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WHAT IS INHIBITED SEXUAL DESIRE? Inhibited desire, or loss of libido, refers to a decrease in desire for, or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some antidepressants; and relationship difficulties.
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refer you to other health professionals, including a urologist (a doctor specializing in the urinary tract and male reproductive system), sex therapist, and other counselors.
fitness fundas
PUMP It UP
chest
inCline duMBBell Chest press target muscle: pectoralis major (clavicular head â&#x20AC;&#x201C; upper chest), anterior deltoid and triceps execution: set up an incline bench at an angle of 45 degrees, select an appropriate pair of dumbbells and lie down on the bench. Hold the dumbbell exactly over your shoulders with extended elbows, this becomes your starting position. Inhale and decscend the dumbbell down making right angle at the elbow joint. Exhale and push the dumbbell up contracting your upper chest muscle back to the starting position. You can perform minimum 3 sets of 15 to 20 repetitions each.
peC-deC Chest fly target muscle : Overall pectorals execution : sit down on a chest ďŹ&#x201A;y machine in a back rested position. Grab the handles of the machine and pull the cable in front of your chest with elbows locked, this becomes your starting position. Inhale and allow the handles to go behind naturally such that elbows & shoulders are in one line. Exhale & push the handles in front back to starting position contracting chest muscles. Perform 3 sets 15 repetitions minimum
Chest sCoop fly target Muscle: Pectoralis major ( clavicular head ) execution: Grab the handles of the cable crossover machine from angle coming from bottom and hold it steady besides your shoulders. This becomes your starting position. Exhale and push both the cables together diagonally from down to in front of upper chest contracting it to its full extent. Inhale and release the cables slowly back to the starting position. Perform 3 sets and 20 reps minimum
Wide grip lat pull doWn target : Latassimus Dorsii (upper back) execution: Sit down on a Lat Pull machine facing chest towards the machine. Grab a wide Grip on the handles . This becomes your starting position. Exhale and pull the handle bar down towards your chin contracting the upper back muscles. Inhale & release the barbell back to starting position.
Location Courtesy: Gold’s Gym, Bandra, Mumbai. Training Text: Sagar Fitness expert, Gold’s Gym. Model: Prateik Jain Photographer: Nilendra Singh
Prateek Jain is an Indian model, actor and the winner of Provogue MensXP Mister World India 2014. He represented India at Mister World 2014 and was among Top 10 Finalists. In 2015, he won Asian Supermodel Contest held in China. He is the first Indian man to win the Asian Supermodel Contest
Acid Reflux Acid Reflux or Gastroesophageal reflux disease (GERD) occurs when acidic liquid contents from stomach frequently back up into the food pipe from the stomach. This flow back can irritate the lining of the food pipe (esophagus) causing either injury of the esophagus lining(erosive esophagitis) or just inflammation (non erosive esophagitis) Mild GERD (acid reflux occurring only once a week) is quite common and may be managed with some lifestyle changes and mild over the counter medicines but severe GERD (Acid reflux once a day) may need stronger medications or in refractory situations even surgery to ease symptoms. WHEN TO CONSIDER GERD You should suspect GERD if you feel • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night • Chest pain • Difficulty swallowing • Regurgitation of food or sour liquid • Sensation of a lump in your throat Patients with severe reflux or
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of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again. If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backflow of acid irritates the linWHAT CAUSES ACID REFLUX GERD is caused by either a condition ing of your esophagus, often causing that causes increased acid output (ex- it to become inflamed which can subsequently develop erosions. cess refluxate volume) or when the junction of the food pipe and stomPREDISPOSING FACTORS ach has loose /weak muscle valve. Conditions that can increase your risk Acid reflux occurs when the LES of GERD include: doesn’t close properly or tightly enough. A faulty or weakened LES al- • Obesity • Hiatus hernia (Stomach bulges tolows digestive juices and stomach wards Esophagus because of weak contents to rise back up into the lower esophageal sphincter) esophagus. When you swallow, a circular band of • Pregnancy • Scleroderma muscle around • Delayed the bottom night time reflux may also complain of • Chronic cough • Laryngitis • New or worsening asthma • Disrupted sleep
DR SHANTI SWAROOP DHAR Consultant,Gastroenterology Max Hospital, Gurgaon & Max Multi Speciality Centre, Panchsheel Park, Delhi
stomach emptying Aggravating factors • Smoking • Eating large meals or eating late at night • Eating trigger foods rich in fat or fried • Drinking certain beverages, such as alcohol, carbonated drinks, coffee, tea and caffeine rich energy drinks. • Medications like aspirin, painkillers LONG TERM PROBLEMS Over time, chronic injury to the esophagus can cause: • Narrowing of the esophagus (esophageal stricture). Damage to the lower esophagus from stomach acid causes scar tissue to form. The scar tissue narrows the food pathway, leading to problems with swallowing. • An open sore in the esophagus (esophageal ulcer). Stomach acid can wear away tissue in the esophagus, causing an open sore to form. An esophageal ulcer can bleed, cause pain and make swallowing difficult. • Precancerous changes to the esophagus (Barrett's esophagus). Damage from acid can cause changes in the tissue lining the lower esophagus. These changes are associated with an increased risk of esophageal cancer. However this type cancer is very rare, even in people with Barrett’s esophagus. WHEN TO SEEK HELP Please see a Doctor if you: • Experience severe or frequent GERD symptoms • Take
medicines for heartburn more than twice a week • Severe chest pain with breathlessness and left arm or jaw pain may be a symptom of heart disease. Immediate medical help should be sought in such a situation.
mand or hospital protocol. • 24 hour Ambulatory acid (pH) and DIAGNOSIS Impedance probe test. A monitor is Doctors usually diagnose GERD placed in your esophagus to identify based on symptoms and physical ex- when, and for how long, stomach amination. Some times a short dura- acid regurgitates there. The monitor tion of treatment with mild antacids connects to a small computer that may be advised to see for response you wear around your waist or with a especially in the absence of any wor- strap over your shoulder. The monirying symptoms. tor might be a thin, flexible tube Further evaluation for diagnosis con- (catheter) that's threaded through firmation or for refractory symptoms your nose into your esophagus, or a includes clip that's placed in your esophagus • Upper gastrointestinal endoscopy. during an endoscopy and that gets The doctor inserts a thin, flexible passed into your stool after about tube equipped with a light and cam- two days. Nowadays even low acid era (endoscope) down the throat, to but high volume reflux can be diagexamine the inside of esophagus and nosed using the impedance probe. stomach. Test results can often be • Esophageal manometry. normal when reflux is present, but Esophageal manometry measures an endoscopy may detect inflamma- the coordination and force exerted tion of the esophagus (esophagitis) by the muscles of the esophagus. or other complications. An enThis is primarily used to diagnose doscopy can also be used to collect a disorders of normal rhythmic sample of tissue (biopsy) to be tested esophageal movement but has a role for complications such as Barrett's in GERD specially before consideresophagus. This endoscopy can be ing a surgical option. done either with or without sedation • X-ray of your upper digestive sysdepending on patient comfort/detem. X-rays are taken after the patient drinks a chalky liquid (Barium) that coats and fills the inside lining of the digestive tract. The coating allows the doctor to see a silhouette of your esophagus, stomach and upper intestine. These tests are not the first line investigations any more and are more of a historical footnote yet they are sometimes useful in patients who cannot or will not undergo an endoscopy. They can also help to diagnose a narrowing of the esophagus
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that may interfere with swallowing. The obvious reason this investigation has receded into the background is lack of actual visualization and not able to obtain biopsies. TREATMENT The first step in management is lifestyle modification like eating an early meal, increasing physical activity, avoiding fatty and fried food. Stopping smoking, alcohol use and carbonated drinks. Cutting down significantly on tea and coffee. Elevation of head end of bed may help in night time reflux. Some medication as follows may also be tried for a short duration of time • Liquid Antacids: Antacids, such as Digene, Mucaine gel and Gaviscon etc. may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or sometimes kidney problems. • Medications to reduce acid production: These medications - known as H-2-receptor blockers include famotidine and ranitidine. H-2-receptor blockers don't act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. • Medications that block acid production and heal the esophagus: These medications - known as proton pump inhibitors - are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Although these medications bring quick relief they should not be used indiscriminately and long term as that can lead to serious infections and deficiencies. • Medication to strengthen the lower esophageal sphincter. Baclofen may ease GERD by decreasing the frequency of relaxations of the lower esophageal sphincter. Serious side effects might include fatigue or nausea and even loss of consciousness. This medicine should strictly be taken only under medical supervision and in very selected situations. SURGERY GERD can usually be controlled with medication. But if medications don't help or you wish to avoid long-term medication use, your doctor might recommend: • Fundoplication: The surgeon wraps the top of your stomach around the lower esophageal sphincter, to tighten the muscle and prevent reflux. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. The wrapping of the top part of the stomach can be partial or complete.
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Preimplantation Genetic Testing Preimplantation Genetic Testing, as the name itself implies, involves genetic evaluation of the embryo before it is implanted into the uterus. It includes Preimplantation Genetic Screening (PGS) as well as Preimplantation Genetic Diagnosis (PGD). Although the terms PGS and PGD are often used interchangeably, yet there is a slight difference in the procedure involved. Preimplantation Genetic Screening (PGS)involves screening of an embryo for any genetic defect, irrespective of the presence or absence of any family history of a genetic disease. PGS is done when a genetic defect is suspected in the embryo. While Preimplantation Genetic Diagnosis (PGD), is done to indentify a specific genetic defect in the embryo. Both PGS and PGD are combined with the IVF (In-Vitro Fertilization) process. PGS is usually done in the cases where couples are suspected to have a genetically abnormal baby. It is commonly done when the age of the mother is more than 35 years. As the age of the mother increases, the probability of having an abnormal baby (e.g. baby with Down Syndrome) increases. This occurs
DR DEEPAK GOENKA Director, Institute of Human Reproduction, Guwahati
DR ANTIMA RATHORE Consultant (IVF Specialist) at Institute of Human Reproduction,Kolkata
PGS involves screening of an embryo for any genetic defect, irrespective of the presence or absence of any family history of a genetic disease. PGD is done in the cases where either one or both of the parents are having a genetic problem or are carrier of any genetic defect, or they have a family history of some genetic disorder.
5 or Day 6 (i.e. Blastocyst Stage) and then, biopsy is performed to obtain adequate number of trophoectodermalcells for genetic testing. Trophoectodermcells are the cells which are destined to form placenta and membranes around the growing baby. They resemble the cells of the embryo, which forms the baby as they share the origin. During earlier days, biopsy was taken from Day 3 embryo (6-8 Cell stage). The main limitation of Day 3 embryo biopsy was that only 1-2 cells could be taken for testing, which may not represent the actual genetic make-up of the whole embryo.Moreover, embryos at such an early stage may sometimes repair themselves i.e. auto correct. Now, with the advancement in the culture techniques, embryos can be grown till day 5-6, and more number of cells can be used for testing. It decreases the chances of error. Trophoectoderm due to the aging of the egg which causes genetic problems during its fertilization. It is also done in Biopsy is the recommended method in PGS/PGD. Cells obtained from biopsy are subjected to the cases where the quality of egg or sperm is proper diagnostic method. Earlier, FISH (Fluorespoor due to any cause. It has been observed that cent In-Situ Hybridization) was used to detect the the fertilization of defective gametes leads to gegenetic defects. However, the main limitation of netic defects in the embryo. With the recent adFISH was that only few chromosomes can be anavancements, PGS is also offered to the couple lyzed at a time. As the number of chromosomes having recurrent miscarriages, and prolonged or being analyzed increases, the sensitivity of the unexplained infertility, as many times the cause behind the pregnancy failure and abortions, is an FISH decreases and the error in the results inundiagnosed genetic problem in the embryo. For creases. At present, the recommended technique of genetic evaluation for PGS/PGD is mCGH (mithe same reason, it is justified to offer PGS to the croarray Comparative Genomic Hybridization). patients who have repeated IVF failures. PGD is done in the cases where either one or both mCGH can be used to test all the chromosomes at of the parents are having a genetic problem or are the same time. It also allows more detail evaluacarrier of any genetic defect, or they have a family tion of genes on a chromosome. As the field of gehistory of some genetic disorder. It is also offered netics is evolving at a revolutionary speed after the completion of Human Genome Project, even in the cases where parents have one of the previmore advance techniques like NSG (Next Generaous child affected by a genetic disease. In such cases the evaluation involves the identification of tion Sequencing) is being used by many centers. the defective gene and subsequent identification NGS is highly sensitive and it allows even more detailed evaluation of genes at molecular level. of the same gene in the embryo. Therefore, in PGS/PGD not only helps in selection of a geneticontrast with the PGS, PGD involves a more tarcally healthy embryo for transfer which increases geted approach. PGD can also be used for selection of an appropriate stem cell donor among the the chances of pregnancy, but also avoids implantation of abnormal embryo which could lead to embryo. miscarriage or birth of a defective or an affected Couple opting for PGS/PGD, first undergo the baby. Therefore, helps in reducing the mental process of IVF (In-Vitro Fertilization)through trauma to the parents. ICSI. Embryos, thus formed, are cultured till Day
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fitness fundas
hip thrusters target: Gluteus Maximus (hips ) execution: Lie down with only half of your body rested on a ďŹ&#x201A;at bench and other half outside the bench descending on the ďŹ&#x201A;oor. Place an empty or weighted Barbell as per your comfort on the pelvic bone . This becomes your starting position. Exhale and push the hip upwards with force contracting the Gluteus muscles Inhale and slowly return back to the starting position. Repeat for 3 sets 15-20 reps
Lower Body
Work out
A step-by-step guide to maximize your workout.
kneeling squats target: Gluteus Maximus execution: Grab a barbell and rest it over your upper traps muscles (slightly below neck). Go down into kneeling position with hips touching your heels initially. This becomes your starting position. Exhale and push the hip upwards into a completely kneeling position contracting the Gluteus Maximus. Inhale and return back slowly to the starting position. Repeat for 3sets 20 reps.
kettle Bell sWing target: Gluteus Maximus execution: Stand with a wide stance and kettle bell placed between your feet. Bent down with ďŹ&#x201A;at back and grab the kettle bell with one arm. This becomes your starting position. Exhale and swing the kettle bell upwards pushing your hips forward and lean behind in your low back slightly. Inhale and return back to the starting position. Repeat with other arm as well. Perform 3 sets 15-20 reps
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BarBell squats target: Quadriceps, Glutes, Hamstring execution: Stand with hip width distance stance in your legs. Rest the barbell on your upper traps (slightly below neck). Stand with upright posture with core hold tightly. This becomes your starting position. Inhale and sit behind slowly making right angle at knee joint or thighs parallel to ďŹ&#x201A;oor. Exhale and push your body up contracting your Quadriceps and Gluteus muscles. Repeat for 3 sets and 20 reps
duMBBell step up target: Quadriceps, Glutes execution: Stand with an upright posture with comfortable Dumbbells closer to the step board. Place one leg on to the step board with knees making right angle. This becomes your starting position. Exhale and step up extending the ďŹ rst leg (contracting the Quadriceps & Glutes )which was on top and resting the other leg parallel to the ďŹ rst one. Inhale and step down back to the starting position position. You can do 10-15 reps on one leg and repeat the same with other for 3 sets.
prone haMstring Curls target: Hamstrings execution: Lie on a Hamstring curl machine in a prone position (facing the ďŹ&#x201A;oor) . Adjust the roller pad of the machine between your calves and ankles and legs straight completely. This becomes your starting position. Exhale and curl your knees completely contracting the Hamstrings. Inhale and return back slowly to the starting position. Repeat for 3 sets 15-20 reps
suMo squats target: Quadriceps & Glutes execution: Stand with a wide stance (wider then you hips) in your legs with toes pointing slightly outwards. Rest the Barbell on upper traps. This becomes your starting position. Inhale and sit down like a sumo with knees moving outwards and making right angles. Exhale and push your body up extending at the knee joint contracting the Quadriceps and Glutes. Repeat for 3 sets 15-20 reps
leg extension target: Quadriceps execution: Sit down on a leg Extension Machine . Adjust the seat back rest as per your comfort. Adjust the roller pad between your shin bone and ankles . This becomes your starting position. Exhale and extend your knees making them straight contracting the Quadriceps. Inhale and return back slowly to the starting position. Repeat for 3 sets 15-20 reps
Location Courtesy: Gold’s Gym, Bandra, Mumbai. Training Text: Sagar Fitness expert, Gold’s Gym. Model: Sony Kaur Photographer: Nilendra Singh Sony Kaur is one of India’s top models. The Hyderabad beauty has shot for Shivan Narresh, Vikram Phadnis, Tarun Tahiliani, Rajat Tangri and Krishna Mehta amongst others and walked for Lakme Fashion Week.
CEREBROVASCULAR STROKE Stroke (CVA) is a devastating disease. It cripples the active life leading to handicap and physical dependence. It leads to loss of productive years and burden to care givers. Except age, most of other stroke risk factors are preventable and controllable. It can affect any age group, thanks to lifestyles and food habits. Symptoms vary from loss of speech, loss of memory, walking difficulty to completely bed bound state or death.
DR MUKESH KUMAR Consultant in Neurosciences at Max Hospitals, Gurugram & Delhi
likely to cause coma than ischaemic stroke, due the increase in pressure in the brain. RISK FACTORS Unavoidable risk factors Age greater than 60 (risk of stroke doubles every decade), male sex, family history of stroke, racial origin. Avoidable risk factors Hypertension, Diabetes, Smoking, Excess Alcohol consumption, Obesity, Lack of exercise. Age more than 65 years and male sex has higher preponderance compare to younger age and female sex. Hypertension contributes to 80-85% cases of stroke. Association of Diabetes with hypertension increases the stroke risk by three fold. The risk of stroke is two times higher in smokers. Alcohol consumption increases the risk of brain hemorrhage.
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troke incidence and prevalence in India is variable over demographics and cultural differences. The estimated adjusted prevalence rate of stroke range is 84262/100,000 population in rural and 334-424/100,000 in urban areas. The incidence rate is 119-145/100,000 population based on the recent population based studies. It also varies city to city and different part of country. Kolkata has around 42% case fatality rate. Case fatality rate means chances of death due to stroke. Studies from India have shown a 2 to 3 time's high prevalence of hypertension, hyperlipidemia, obesity, diabetes mellitus, and smoking (in men) in urban compared to rural communities. Stroke is a treatable and preventable disorder. It should be identified early for better recovery. Brain cells dies fast as the time progresses. In each minute, 1.9 million neurons, 14 billion synapses, and 12 km (7.5 miles) of myelinated fibers are destroyed. Stroke is a disease defined as a sudden neurological deficit (e.g. weakness, loss of sensation or other) due to a vascular cause. The deficit must last for longer than 24 hours and is of sudden onset. There are two main types: 1. Ischaemic (85%): can be due to a thrombus (a clot forming in one of the blood vessels supplying the brain); or due to an embolus â&#x20AC;&#x201C; a clot which travels from another site (usually the heart) to block off one of the arteries in the brain. 2. Haemorrhagic (15%): this is due to rupture of one of the arteries in the brain â&#x20AC;&#x201C; usually due to an aneurysm (an outpouching of an artery â&#x20AC;&#x201C; causing a point of weakness) The onset of the stroke is usually sudden, although it can evolve in a step-wise manner over several hours in thrombotic stroke. After its development, the neurological deficit may improve gradually over the next few weeks to months, and sometimes it may completely improve, although most patients are left with a residual deficit. A TIA (or transient ischaemic attack) has the same symptoms as a stroke, but the symptoms last for less than 24 hours and associated with complete recovery. Haemorrhagic stroke also occurs suddenly, though it is usually accompanied by a severe headache. It is more
HE & SHE
CLINICAL FEATURES Stroke commonly presents with loss of sensory and/or motor function on one side of the body. The patient experiences a sudden inability to move a part or entire limb and/or have abnormal sensations over the affected limb. There might be difficulty or inability to speak and the patient as well as witness notice that there is a change in speech. There might be inability to understand spoken word leading to a confused look from the patient. Other symptoms include loss of vision, loss of consciousness, instability of gait, giddiness and vomiting. Early diagnosis of stroke is extremely important so all patients with symptoms suggesting stroke should be assessed in hospital. In general, any episode of acute onset loss of speech, gait difficulty, facial deviation or loss of consciousness should be considered a stroke and the person should be transferred to nearest hospital. In short term, it is mentioned as FAST (F-face deviation, A-arm drift, S-loss of speech or aphasia, T- time of onset). DIAGNOSIS A non contrast CT scan is invaluable in acute situation to rule out hemorrhagic stroke and guide further management course. CT scans may not detect an ischemic stroke, especially if it is small, of recent onset, or in the brainstem or cerebellum areas. A CT scan is more to rule out certain stroke mimics and detect bleeding. MRI brain is the modality of choice for lesions involving posterior fossa and provided much more detail as compared to NCCT. CT or MR angiography of neck and brain vessel is required to delineate the vascular structure and screen for vascular stenosis and dissection. ECG and 24 hour Holter monitoring help in diagnosing underlying arrhythmia which guide treatment modalities. TREATMENT There is radical change in management of stroke in last
two decades. Stroke survival and disability free state are improving with general awareness and timely intervention and improved rehabilitation strategies. All ischemic strokes may receive thrombolytic therapy (clot buster) within 4.5 hours of stroke onset. The treatment of a patient with stroke is divided into immediate and long-term management. Immediate treatment is different for ischaemic and haemorrhagic strokes but general principles of management for both are listed: • Blood glucose monitoring • Blood pressure control • Cardiac monitor- ECG for ischemic changes or atrial fibrillation • Intravenous fluids • Oxygen- If hypoxic • Maintaining normal temperature.
HAEMORRHAGIC STROKES Haemorrhagic strokes are managed differently acutely. The patient is not given Aspirin for fear of further bleeding, and if there are signs of increasing ICP (intra-cranial pressure) urgent neurosurgical treatment is sought. Hypertension should be controlled.
SURGERY Surgical removal of the blood clot causing the ischemic stroke may improve outcomes if done within 7 hours of the start of symptoms in those with an anterior circulation large artery clot. It however does not change the risk of death. Significant complications occur in about 7%. Intravenous thrombolysis is generally used in eligible people even if they are being considered for mechanical thrombectomy. Certain cases may benefit from thrombectomy up to 24 hours after the onset of symptoms. THROMBOLYSIS Strokes affecting large portions of the brain can cause Thrombolysis, such as with recombinant tissue plassignificant brain swelling with secondary brain injury in minogen activator (rtPA), in acute ischemic stroke, surrounding tissue. Relief of the pressure may be atwhen given within three hours of symptom onset results tempted with medication, but some require hemiin an overall benefit of 10% with respect to living withcraniectomy, the temporary surgical removal of the skull out disability. It does not, however, improve chances of on one side of the head. This decreases the risk of death, survival. Benefit is greater the earlier it is used. Between although some more people survive with disability who three and four and a half hours the effects are less clear. would otherwise have died. A 2014 review found a 5% increase in the number of people living without disability at three to six months; HEMORRHAGIC STROKE however, there was a 2% increased risk of death in the People with intracerebral hemorrhage require supportshort term. After four and a half hours thrombolysis ive care, including blood pressure control if required. worsens outcomes. These benefits or lack of benefits oc- People are monitored for changes in the level of concurred regardless of the age of the person treated. There sciousness, and their blood sugar and oxygenation are is no reliable way to determine who will have an inkept at optimum levels. Anticoagulants and antithromtracranial bleed post-treatment versus who will not. botics can make bleeding worse and are generally disWhen administered within the first three hours thromcontinued (and reversed if possible). A proportion may bolysis improves functional outcome without affecting benefit from neurosurgical intervention to remove the mortality. 6.4% of people with large strokes developed blood and treat the underlying cause, but this depends substantial brain bleeding as a complication from being on the location and the size of the hemorrhage. given tPA thus part of the reason for increased short term mortality. Intra-arterial fibrinolysis, where a REHABILITATION catheter is passed up an artery into the brain and the Stroke rehabilitation is the process by which those with medication is injected at the site of thrombosis, has disabling strokes undergo treatment to help them rebeen found to improve outcomes in people with acute turn to normal life as much as possible by regaining and ischemic stroke. relearning the skills of everyday living. It also aims to help the survivor understand and adapt to difficulties, ISCHAEMIC STROKES prevent secondary complications and educate family The patient should be admitted into a dedicated stroke members to play a supporting role. unit with multidisciplinary staff for rehabilitation. Aspirin A rehabilitation team is usually multidisciplinary as it (300mg) should be given. The patient’s swallowing ability involves staff with different skills working together to should be tested (by a speech therapist) and a naso-gashelp the patient. These include physicians trained in retric tube should be given if required to prevent aspiration. habilitation medicine, clinical pharmacists, nursing Long term medical management focuses on reduction of staff, physiotherapists, occupational therapists, speech cerebrovascular risk to reduce recurrent stroke. Low dose and language therapists, and orthotists. Some teams aspirin (+/-clopidogrel) is typically prescribed to prevent may also include psychologists and social workers, since formation of further clots. Other management of stroke at least one-third of affected people manifests post includes changing lifestyle factors (increased exercise, stroke depression. healthy diet and smoking cessation), reduced blood pres- Good nursing care is fundamental in maintaining skin sure, lipid control (with statins) and strict blood glucose care, feeding, hydration, positioning, and monitoring control. Thus additional management will depend on in- vital signs such as temperature, pulse, and blood presdividual patient factors and concurrent disease. sure. Stroke rehabilitation begins almost immediately.
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Children’s Health
DR SAGAR BHATTAD Paediatric Immunologist, ASTER CMI Hospital, Bangalore
Primary Immunodeficiency In Children IMMUNE SYSTEM IS OUR ARMY – WHAT IF, IT FAILS TO PROTECT US? All living beings including humans have an efficient immune system that protects us from infections. The orchestra of the immune system is made up of players who defend the human body against pathogens like bacteria, virus, protozoans and many more. It is akin to an army that is made up of various levels of defense, each member coordinates with the other to defend the kingdom, the kingdom of human health. Unfortunately, nature fails to provide the necessary armamentarium to some children. These children, in the absence of one of these soldiers cannot effectively fight pathogens and thereby get repeatedly ill. The group of diseases in which children are prone to recurrent infections due to a defect in the immune system are called Primary Immune Deficiency Diseases. Unfortunately, physicians and pediatricians are not well versed with these diseases and this may result in undue delay in the diagnosis. MAGNITUDE OF THE PROBLEM Primary Immune Deficiency diseases are by no means ‘rare’. As per research conducted worldwide, 1 in 2000 children suffer from an immune deficiency. If these figures are extrapolated to the city of Bangalore, around 5000 children have immune deficiency disease. Unfortunately, majority of these children remain undiagnosed and suffer for years. There is an urgent need to increase awareness amongst doctors and public about these diseases. WHAT ARE THE SYMPTOMS? • Chest infection – children with problems in the immunity are prey to frequent chest infections. They may require hospitalisations for treatment of these ailments repeatedly.
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• Ear discharge – Recurrent episodes of ear-discharge can be a feature of underlying immune defect. • Loose motions – Repeated episodes of loose motions/diarrhea or diarrhea that takes unusually longer days to resolve, warrants evaluation by an immunologist. • Not gaining weight and height – Healthy children gain weight and height as per age norms. If a child fails to achieve his/her potential, a problem in the immune system must be sought for. • Death of children in the family – Some immune deficiencies are serious conditions and if untreated, such children die at young age. If you come across families who have lost children due to infections, one must advise them to meet an immunologist. HOW CAN THESE CHILDREN BE DIAGNOSED? If you come across children who remain unwell, kids who visit doctors very often, kids who are often hospitalised, ask them to contact an immunologist. By performing a few blood tests, the doctor would determine if there is any problem in the immune system of the child. Commonly asked immunological tests are serum immunoglobulins (IgG, IgA and IgM), however the battery of tests would vary based on the problems in a given child. TREATMENT FOR THESE CHILDREN? Children who have problems in immunity require special care and treatment. Injections that boost their immunity (immunoglobulins) can be given. For children with more serious defect in immunity, bone marrow transplant can be offered. If treated in time, these children lead a healthy and normal life.
• Children
with frequent infections need appropriate evaluation. • Frequent episodes of ear discharge or lung infection and/or failure to grow normally warrants assessment of immune functions. In such settings, one must contact an immunologist. Simple blood tests can offer a solution to the ongoing problems. • Children with immune defect, if treated appropriately, grow out to become productive citizens.
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preserve your FERTILITY for the FUTURE DR SHEFALI JAIN Infertility Specialist, Gynecologist & Obstetrician at Asian Institute of Infertility Management, Indore
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iddhayani was a medical student doing post-graduation in gynecology. She was multi-dimensional, extrovert and a hard working girl. Her orthodox parents insisted that she marry and then continue her studies in accordance to the wishes of her in-laws, without realizing the potential and abilities of the girl Unfortunately, in spite of so much success in life, her marriage turned out to be a failure because ‘He’ was not ‘Mr Right’ for her. The marriage finally ended in separation & divorce. Siddhayani turned so bitter, that any hope of finding a suitable boy and remarriage was non existant in the present scenario. She never wanted to enter into a wedlock, but, the thought of motherhood gave her a lot of solace and peace. If she finds a suitable match in the future, can her dream be fulfilled …? Misthi, a young girl, enjoying college life after the strict school discipline. Her life turned topsy turvy when her blood report diagnosed acute leukemia. Now life would revolve around chemotherapy /radiotherapy & other medical treatments. Now what is the future of these young innocent girls ? A difficult time for the whole family. In this disastrous life’s turmoil apart from the agony of disease and its treatment, comes the great sorrow, despair and helplessness of possible infertility.
Q. WHAT IS OOCYTE (EGG) FREEZING? A. The preservation of oocytes (egg) removed from the woman’s ovary in order to retain the possibility to reproduce with their own gametes at a later stage of life. Q. WHY FREEZE OOCYTES AT YOUNGER AGE? A. As woman's age advances, the quality and the quantity of eggs deteriorate. The likelihood of chromosomal abnormality, risk of miscarriage and birth defects increase.Therefore younger the age better the prognosis for the future. Q. IS THE PROCEDURE PAINFUL? A. Procedure should not be feared. The procedure involves injections, which are given for 810 days subcutaneously i.e. under the skin which are like mosquito bites. The eggs are retrieved under anesthesia & is some somewhat similar to withdrawal of a blood sample. Q. WHAT IS THE ACTUAL PROCEDURE OF EGG FREEZING? A. The process of egg freezing or oocytes cryopreservation, involves stimulating the ovaries with hormones to produce multiple eggs. Once eggs form under the influence of hormone injections, they are retrieved using a needle through the vaginal route. This procedure takes 5-10 minutes and is done under short anesthesia. After retrieval of oocytes, they are frozen.
Q. CAN ONE CONTINUE TO WORK DURING THIS PROCEDURE? Fertility preservation is a ray of hope offered by A. Yes of course, work can be continued during doctors, counsellors & the support system. treatment cycles. You may skip your office or This helps young girls like Misthi, along with the work on the day of ovum pickup as the procefamily to navigate their path through the diffidure involves short anesthesia after which you cult decision making process of the treatment as may feel little dizzy for some time. well as the fertility preservation options for future. Q. DOES OOCYTES FREEZING GUARANTEE A BABY? Now, the question is ‘Is fertility preservation A. No procedure in the world can guarantee a through cryopreservation of oocytes (egg freez- baby currently. According to a study published ing) a realist approach or just a delusion.’ in the Journal Human Reproduction, predicts that women under 35 who freeze 10-20 eggs Apart from the known risk of fertility comprohave between a 70 and 90% chance of at least mise in cases of malignancies, other conditions one live birth later on. like unavoidable delay in marriage, unstable couple relationships, autoimmune diseases, im- Q. HOW MUCH DOES IT COST? pending risk ofpremature ovarian failure are A. An egg freezing cycle may approximately cost also the few more indications of oocyte freezing. from 1.5 Lakhs to 2 Lakhs.
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The Nordic Diet WHAT IT IS, HOW IT WORKS... WHERE’S IT FROM? The Nordic countries include Denmark, Finland, Norway, Iceland, Sweden, and Greenland. The “Nordic diet” is based on their traditional ways of eating. Like the more famous Mediterranean diet, it’s not really about weight loss. Instead, it's a delicious way to eat healthy. So, what foods does it include?
WHAT CAN YOU EAT? This style of eating is based on these guidelines: • More fruits, vegetables, and seasonal and organic foods when possible • More whole grains • More food from seas, lakes, and the wild • Higher-quality meat and less of it • Less processed, less sugary foods • Cook at home more • Waste less
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Like the more famous Mediterranean diet, it's not really about weight loss. Instead, it's a delicious way to eat healthy. See what foods are included.
WHOLE GRAINS Think whole-grain crackers from Sweden or the dark, dense sourdough rye bread from Denmark called rugbrod. Or you can also choose any other high-quality “complex” carbohydrates that are rich in fiber. They also have lots of vitamins, minerals, and antioxidants that help protect your cells. BERRIES They’re a big part of the Nordic way of eating and when you eat lots of them, you’re less likely to gain weight. They’re also a good source of antioxidants called anthocyanins, which seem to keep your veins and arteries healthy and flexible, and may help lower your blood pressure.
CANOLA OIL The Mediterranean and DASH diets include olive oil. The Nordic diet generally uses canola oil instead. Like olive oil, it’s low in saturated fat and higher in healthy monounsaturated fat. Also, it has alphalinolenic acid, an omega-3 that may help protect your brain, including from stroke.
ROOT VEGETABLES AND TUBERS Carrots, parsnips, beets, and potatoes are typical. Though they can be high in calories, they also give you fiber, which takes longer to digest and keeps your blood sugar more stable. And they’re loaded with nutrients that help protect your cells, lower your cholesterol, and help fight infection.
FATTY FISH They have certain omega-3 fatty acids that your body can’t make. These could lower your chance of having heart rhythm problems, lessen plaque buildup in your arteries, and cut down on fat in your blood (triglycerides). You might know about salmon, sardines, and albacore tuna. Nordic cultures like herring and mackerel too, which they cook, but also dry, pickle, and ferment. Shoot for two to three servings a week.
NUTS AND SEEDS They’re a source of complex carbs and fiber, as are whole grains, berries, and vegetables. They’re rich in zinc, copper, potassium, vitamin E, niacin, antioxidants, and mono- and poly-unsaturated fats (MUFAs and PUFAs).
BEANS AND PEAS The Nordic diet recommends them as one of the major sources of complex carbs and fiber in your daily diet, along with whole grains, berries, and vegetables. They’re a great source of protein, especially to replace some of the calories you get from red meat. And they have lots of nutrients like riboflavin, B6, calcium, zinc, and iron.
ADVANTAGES OF GOING NORDIC Cholesterol This way of eating may help lower “bad” (LDL) cholesterol in people who start out with higher than normal LDL levels. And it may work even for people who don’t lose weight on the diet. You should get a cholesterol blood test every 4 to 6 years - more often if you have heart health problems.
Type 2 Diabetes As with heart disease, this approach helps ease some of the issues linked to type 2 diabetes, like inflammation and obesity. That’s why many doctors figure it probably helps prevent the disease over the long term.
Heart Disease Unhealthy cholesterol, blood pressure, glucose, and insulin levels are all “risk factors” for heart disease -that is, they make you more likely to get it. Because the Nordic diet seems to improve these issues in many people, scientists think this way of eating might help support heart health, too.
It’s Green, Too! One of the main goals of the Nordic diet is to be environmentally friendly. So while it’s good for your health to eat a diet that’s more plantbased than animal-based, it’s also good for the planet. That’s because plant-based foods are less taxing on the land, the climate, and the atmosphere. So stay healthy and do something for the Earth while you’re at it.
Inflammation It means the swelling of tissues all over your body, and it’s linked to disObesity eases like diabetes, heart disease, When people shift to this way of eat- and high blood pressure that can ing, they tend to lose weight, espelessen the quality and length of your cially the fat you carry around your life. A healthy Nordic-style diet waist. That’s better for you than los- seems to be a good way to keep it ing it from elsewhere on your body. away. Of course, diet is not the only And if you follow this plan, it may cause. It’s important to get regular help you keep those pounds off. exercise and sleep well, too.
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Luxury in the lap of Nature
Regalia THE
LUXURY RESORT
pamper and comfort your body in the most luxurious beds after an adventurous trip or a fun filled day.
stands true to its name – giving the most royal treatment to its guests. The Regalia aims to pamper the guests withthe best services and amenities. It’s a destination for the finest accommodation. The luxurious ‘Bay View Cottages’ have been built with utmost care and passion. Built with the best Siberian Pine Wood the stay is eco- friendly. The cotengage yourself in tages are comfortable all year round as the wood stands sturdy and strong in the some fun filled all seasons. The room tones are enwater activities at riched in pastel and earthy hues to the pool. relax the mood. The furniture are elegant and contemporary. The linen used The pristine blue sea, the white sands is of high quality and skin friendly. and the mesmerizing natural surroundings of Ashwem Beach can hold Pamper and comfort your body in the most luxurious beds after an adventurcaptive the mind and soul of all. Built ous trip or a fun filled day. on such a captivating platform, The Regalia Luxury Resort is one of the best Each room has its own private balcony retreats on Ashwem Beach. The Regalia and an en suite bathroom. All private balconies are provided with outdoor Luxury Resort is situated 60 kms from furnishings to unwind and relax at any the airport, 30 kms from Panjim, the capital city, 1.5 km from the local mar- time. Slide the curtains to reveal the ket, at close distance from major night floor-to-ceiling towering glass window clubs of North Goa and has good con- and let the natural light seep in to the cozy rooms. Be it day or night, breathe nectivity with other parts of Goa. in the freshest sea breeze in the beauti“The Regalia” signifies royalty and it
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ful tropical forest for the ultimate holidays. Enjoy some private moments away from the busy city life with your loved ones. Holidays are to forget the worries and unwind the mind for the fresh start. The Bay View Cottages are provided with all modern amenities and all basic services for that new start. The bathrooms are clean and hygienic with all the modern facilities. The cottages at the top are the most sought after for it gives an exclusive mesmerizing view of the horizon. The different shades of blue and green of the Arabian Sea is a special treat to the eye. The poolside area is furnished with comfortable sun-loungers to soak in the sun. The bar and the restaurant services extend to our pool. Sip on some refreshing drink or nibble on some light bites while you cool off with a dip in the pool. The water is clear and clean and filtered with Compact Filtration System making it hygienic at all times. Indulge yourself at ‘The Flare Bar’ for the best in taste cocktails. Satisfy your palate at our multi-cuisine restaurant
Eat, Play, Work, Relax, Unwind
‘Amber Rush’. Treat yourself with the mouthwatering dishes prepared with great passion. The freshest and the finest ingredients used bring the best in taste. We use fresh locally caught fish for the authentic Goan taste. The Regalia Luxury Resort is open all year round for all seasons. The staff at The Regalia are courteous, helpful and diligent to make your stay a memorable one. We serve the guests with utmost priority. We provide an amicable environment for a happy stay. The Ashwem Beach of North Goa is blessed with clear and clean waters of the Arabian Sea. It is one of the well main-
tained beaches of Goa, away from the maddening crowds. Goa offers a climate and a way of life that brings visitors year after year. Be it the solo traveler or a family, whether business or leisure in mind we are an ideal choice for every traveler. The Regalia Luxury Resort built in this picturesque beach is at close distance from the sea. A nature’s paradise, amidst the serene sea beach away from the busy crowded shores. So if its nature, peace and quality time you’re looking for, The Regalia is the right choice.
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DREAM DESTINATION • Conference hall with cluster seating for 80 people • Theater sitting for 120 people • Amber Rush our latest multi cuisine restaurant. Great food from Indian to Chinese and continental. Jain food on request (only for groups). • Flare by Amber rush our pool side bar. World class with a wide range of drinks, ideal for pool parties • Flare Lounge • 30 AC rooms including two suites with mini bar, fridge, Tv, locker & coffee maker • Bay view rooms • Executive rooms • Pool view rooms and suites • Bathrooms with shower cubicles, rain shower, hair dryer & signature toiletries • Complimentary breakfast at restaurant Amber Rush. • Oxygenated pool free of chemicals & Baby pool • Luwark coffee in rooms daily • Welcome drink on arrival • Airport pick up and drop on request • Beach just 40 meters from resort. • Parking available • 24 hours power backup • High speed 100 mbps wifi • Ideal for Engagement ceremonies, Destination weddings / including beach setup. • Best for couples, family groups & solo travellers • DJ nights on demand. In house DJ • Doctor on call • Travel desk • 24 hours front desk • 24 hours security • CCTv cover all over resort.
the regalia resort Ashwewada, Mandrem, Pernem, Goa - 403 512 (India) Ph: (+91) - 72189 68722, (+91) - 70835 97427 M: (+91) 9850096045 For Reservations & Banquet bookings Call : 9146031007 Email: HEinfo@theregaliaresort.com & SHE Website: www.theregaliaresort.com
