Wednesday, May 19, 2010

Don't let urinary tract infections go unnoticed

Dr R K Shimpi
Uro-surgeon & Andrologist

Are you suffering from pain in your lower abdomen, or have problems of frequent urination and irritation? If yes, it's time you consult your Urologist.
The most common organisms or bacteria which cause this urinary problem are of intestinal origin, like Escherichia Coli, or better known as E Coli. Most women are afflicted by this problem of Urinary Tract Infection during their reproductive years. Right from puberty to the post-menopausal period, women experience it some time or the other. If not dealt with on time, this infection could pose a serious health problem because of its frequent occurrence. The different infections usually occur due to the ascent of bacteria within the urethra. This is the reason why women are more prone to infections due to the short length of urethra and its closeness to the anal verge. The other causes of recurrent UTI are anatomical abnormalities in the urinary tract or obstruction to the urinary tract. The bacteria can multiply in the urinary tract and give rise to a serious bladder infection, which is called cystitis. There are other causative bacteria like Chlamydia and Mycoplasma which are transmitted during sexual intercourse and which travel from the vagina to the urethra.

Symptoms
Often a mild infection will go unnoticed as UTI symptoms are asymptomatic. But, for someone who is prone to recurrent infections, the signs are conspicuous.
The most regular features are heaviness of bladder after passing urine, burning sensation while passing urine, frequent urination but the quantity of urine passed is not much, pain in the lower abdomen and lower back and a cloudy appearance and strong odour of urine. If undetected or untreated for long, the infections may aggravate and lead to passing of blood in the urine, known as Haematuria.

Precaution
While a strong course of antibiotics taken for a long duration can tackle the infection, there are a few precautions or steps to be taken to minimise its occurrence. These are:
- Drink plenty of fluids - water and juices - to flush out the bacteria
- Never resist the urge to urinate.
- Keep the genitals clean and dry, especially before and after sexual intercourse.
- It is good to urinate after a sexual intercourse to flush out the bacteria.
- Cotton undergarments are better then synthetic as they allow the skin to breathe and avoid moisture
- Avoid douches or scented toiletries, which can irritate the urethra.
- Always clean the genital area from front to back to prevent organisms from infecting your urinary tract.

Treatment
The treatment for UTI depends on a variety of factors. For an uncomplicated UTI, antibiotic course is recommended for a week or 10 days as per the urine culture and sensitivity report. After the initial course of antibiotics, one should again go for urine culture to check the reduction in the number of pus cells. If there are no pus cells, then the treatment is usually discontinued. But if the problems persist, or the infection is complicated, then after the initial course of antibiotics, long term antibiotics are usually recommended for the complete eradication of the bacteria. But if one gets recurrent UTI then further evaluation and correction of the abnormalities in the urinary tract with long-term antibiotics is required.

- As told to Barnalee Handique

Thursday, May 13, 2010

Marry right or die

In the second honour killing of the month, Delhi-based journalist Nirupama Pathak's mother Sudha was arrested for smothering the 24-year-old to death. The question is how could a middle class family kill its own flesh and blood for merely wanting to marry outside the caste. And why do the honour killings usually occur in urban areas? Does the middle class have a medieval mindset?
In recent cases like Nitish Katara's murder and Rizwanur Rahman's supposed to be suicide, the families did not accept inter-caste and inter-religion marriages. The result was death. A Jat boy from Bahadurgarh, Haryana was forced to separate from the girl he wanted to marry. He is still hiding in Delhi under police protection. In 2008, a Jharkhand couple (belonging to the same Barda gotra) were chained in a room for a week. Their genitals were burnt. In 2009, Neelam was killed by relatives in Rajasthan in an honour killing case. The maha panchyat protested against the arrested of the killers.
The problem needs to be addressed at its roots. The alarming spate of honour killings and how the couple are clinically dealt with are frightening. We come across as people with an extra thick hide: nothing can affect us anymore. Te neighbours, friends and the whole community get involved in the killing. The mob mentality respects no individual.
Is there a solution to the growing problem? Should the situation be so dismal for the young generation?
Family plays a decisive role in an individual's life. Loyalty to clan and caste is surely demanded. It is a calamity if the young fall in love and marry outside caste or religion. That is going against family diktat. This is a transitional phase in India. The country is changing at a different pace at different places. There is conflict between value systems. People are caught in the vortex of conflicts. The victims are mostly women because they still are the property of males irrespective of caste, ethnic or religious group.
Such attitude often forces society and even the authorities to refuse protection to the victims. Often the issues get murkier with no chance of solution. The time has come for us to enact a law that will punish such heinous crimes severely. These cases can't be treated as simple cases of suicide or murder.

Wednesday, May 12, 2010

DOC TALK-THYROID PROBLEM

Suffering from fatigue and depression? It could be a thyroid problem

Dr Uday Phadke,
Endocrinologist & Diabetologist

Did you know that there is a small butterfly shaped gland on your neck called thyroid?This gland, below or beside the Adam's Apple, has an important impact on your health. And to keep healthy, a well-functioning thyroid gland is essential for the all-round development and growth of the body. Every aspect of your metabolism, from your heart rate to how fast you burn your calories depends on the thyroid glands. So in short, you cannot live without the thyroid gland or its hormones.
The gland makes and secretes two major iodine containing hormones (T3 and T4) which act on target cells and different organs of the body and are carried in the bloodstream. Too much or too little of thyroid hormones affects one's health - the immune system in particular thereby making one more vulnerable to diseases. Several factors may throw the thyroid off balance, especially the autoimmune disorder, though researchers do not know what causes these auto immune diseases.

Hyperthyroidism and Hypothyroidism
Around eight per cent of the adult population suffers from thyroid problem. And the problem occurs mostly in women, than in men. It can occur during puberty and can last for as long as you live. Most people with thyroid problems have under-active and overactive hormones. Hypothyroidism occurs when the gland doesn't produce enough thyroxine (hormone).
On the other hand, the over production of the hormones will lead to hyperthyroidism. It occurs when the thyroid gland releases too much, causing metabolism and other organ functions to accelerate. Untreated hyperthyroidism may lead to heart failure and osteoporosis.

Hashimoto's thyroditis, an auto immune condition, is the primary cause of hypothyroidism, the most common thyroid disability. In this disease, antibodies gradually destroy the thyroid hormones, causing a slowdown in the body's system. Most women dismiss symptoms of fatigue and depression as signs of ageing and pre-menopause. However, failure to treat an under-active thyroid can cause anemia, high cholesterol and heart disease.
Therefore it is important to identify and treat Hyperthyroidism (excessive) and Hypothyroidism (less) at the earliest.

Symptoms
Though treatable, a thyroid disease is elusive as only half the people suffering from this problem know about it. The onset may be gradual with symptoms like irritability and insomnia. These symptoms are often confused with depression, stress and menopause, and that is the reason why a malfunctioning thyroid is often undetected. The other symptoms are rapid heart palpitations, weight gain, weakness, weight loss, dyslexia, premature hair greying, hair loss, chronic hives and vitiligo.
People who have a family history of thyroid disease are at a greater risk.
Postpartum thyroditis is an inflammation of the thyroid that occurs in 5-10 per cent of women following pregnancy. It is responsible for most postpartum depression. The problem usually resolves on its own. Some people develop painless lumps on the thyroid and though most of these nodules are harmless, a doctor usually performs a biopsy to evaluate the cells for cancer. An imaging test can also help diagnose the nodules.

Awareness
Be alert about the symptoms, and if you have any, go for the T3, T 4 and TSH tests.


- As told to Barnalee Handique

An input :Why I like mallika Sarabhai...

I was always enamoured by this versatile danseuses forthright and veracious demeanor.I am talking of none other then the pretty and resolute Mallika Sarabhai. She has many dimensions to her character and her journey in life has been fascinating-as a dancer and as a social activist. She has not only chiseled herself to an art form,but is also known for her creative bent of mind. She has always been passionate about her art and knowledgeable about her craft, and modest about her skills. This determined and undaunted social crusader and has been successful in raising awareness,highlighting social issues and advocating change. What endeared me till date is her indomitable spirit and never-say die attitude. Case in point:She fight for the downtrodden with the same verve and energy ,as she did when she offered a tough resistance to the Gujrat Chief Minister Narendra Modi.Her determination, it has taken legendary hues and can serve as an inspiration to many. She was and is the epitome of modest women.It speaks about her unwavering grit and strong will power. I have found myself drawn to this trait in her time and again.

BOOK REVIEW : Road to Jerusalem

THE ROAD TO JERUSALEM
Author: Jan Guillou
Pages : 833
Publisher: Harper Collins
Price:Rs 250

If you are interested in reading a historical thriller with a refreshing perspective on twelfth century religion and society in Sweden, then the aptly named 'The Road to Jerusalem'(The Crusades trilogy)will surely keep you engrossed in the pages.

The story spins round Arn De Gothia who would become a great crusader. Arn the second son of a rich landowner, falls to his apparent death as a youngster but is revived after much praying by his parents. They see their son's survival as a sign that their son is special, and is later sent to a monaster to pursue his education. Under the tutelage of a former Knight Templar, he undertakes scholarly lessons.Finally he ends up being a superb swordsman,a natural fighter and an excellent swordsman. Even his monastery superiors began to think that this was not the place to which god was calling him.
His release from cloistered life of the monastery to the world outside was not easy and his innocence and strength propelled him into remarkable difficulties. His country was at war,rival families including his own were striving for the crown-and no one had expected him ever to emerge from the monastery to claim his heritage. Drinks,women and warfare were all intoxicating,but the penalties imposed for transgressing rules were fierce,in his case,banishment to join Knights Templar.
The tapestry of scenes woven by Guillou's makes us understand life in the Nordic lands, in particular the changing relationships among the clans, the church's role and the politics in general of the time. For me, Arn is a strong lead character who holds the story line together,and the support cast enhances the deep look into Swedish medieval society while also propelling the plot forward.
As you turn the pages,you will appreciate the finer nuances of the society portrayed by Guillou. Arn's life in the monastery was depicted beautifully in the discussions between him and Father Henri. The poignant scene when Arn is about to become a Templar is evident in the lines- “For God and death to all Saracens!” As Father Henri says, “God's children are select, and just as they do not include the thralls (servants) who worship their pagan gods so too can they never include the Saracens, whoare the most nefarious race that the Devil has put on our earth. They are not human beings, they are devils in human form,”according to Father Henri.
Though the novel captivates you, I found the pacing of the novel too slow as one scene unfolds to the other. Arn does not truly become the main character until well into the book, and the first one hundred-fifty or so pages are devoted to setting up the story, and action is minimal, with many scenes devoted to theological discussions between Arn and his elders. At times, it feels as if Guillou is telling the reader what happened, rather than letting the reader experience events through the character, thus subtly distancing the reader on an emotional level.On the positive side, Guillou masterfully immerses the reader in the historical context. The attention to details both great and small, and the plots and machinations make for an intriguing tale. If you enjoy a story unreeled at a leisurely pace, I recommend The Road to Jerusalem.

Celebrating durga Puje

Time has come round again for my favourite festival-durga puja and I am waiting to revel in the festival’s specialities such as the decorations, sumptuous food, rangolis and the rich finery. For me this occasion has special connotation,It’s the time when I get back to my roots and get in touch dormant spiritual side. It’s a time when I follow every tradition connected to this festival. Besides that, it also the time when I get in touch with my entire family.
Durga Puja symbolises the triumph of good over evil. The festival is celebrated for a week, and each day has a mythological significance. Astami or the eight day is the most important day of the entire occasion.. It’s a family time as puja’s are performed.
I remember the days of lavish preparation before the arrival of the deity. A week before the pujas,I helped my mother with the household chores. Garlands of marigold and mango leaves were sewn together,the rice had to be ground for alpanas (rangoli), a variety of mithais to be prepared before the relatives started arriving. other family members start arriving. I remember collecting fresh flowers from the neighbours garden every morning and cleaning the brass thalis to be used for the day’s rituals.
After the days rituals, it is usually time when the entire family sits down for bhog. Bhog is usually made of rice and a mixture of lentils, accompanied labra (a dish of mixed vegetable), papad and dollops of ghee served on banana leaf. And not to forget the rich kheer made with jaggery,ground rice and dates and the delicious rosogollas, mohan bhogs and lal mohans which were simply divine!
In the evening, the entire family usually gather and visit the local puja pandals. It is usually the time when we get to meet and socialise with our friends,relatives and friends. Nearly everyone makes it to the pandal once a day to pray and eat together. The puja pandals are usually choc-a bloc with women resplendent in traditional benarsi sarees with heavy gold embrodiery and matching jewellery,while the men are usually seen in embroidered kurtis and dhotis.
And not to forget the tantalising food stalls set up in every pandal where you get to taste different regional cuisines. Check the different food offered in the stalls, which seems to be the main draw of the pandals. It's quite a sight to see people attacking the food with gusto.
Another aspect I like,during this time it is a revival of culture and tradition. The pandals usually encourages artistic exprerssions through home decorations,stage plays,elocution competitions,cooking competitions thereby discovering talent in younger people.

REVIEW : Flesh House

Book : Flesh House
Author: Stuart Macbride
Price:Rs 250
Pages:480
Publisher :Harper Collins

When much ink has been spilled and reams written eugolising an author and his writings,it makes me wary. The truth, however is that Stuart Macbride is better with each book he has authored. I read the novel in three hours flat while waiting for a dentist's appointment and it certainly helped those dreaded hours melt away.
Like all his other books, Macbride has stuck to the formula of penning down dark funny stories and Flesh House is no different. Surprisingly, in this novel too, he has managed to sustain powerful eyeball glue. It's taught narrative,gut churning incident,strong characterization, are all shot through with savagely dark humor. He makes sure he hooks you from the first page and never lets you go.

The story is written ostensibly within the framework of a particular genre. The grisly tale starts off with a brisk pace when an offshore container turns up at Aberdeen Harbour full of human flesh. The incident kicks off the largest manhunt in the granite city's history. The city is besieged by a cannibalistic killer,who dismembers corpses and has the habit of selling the flesh it in a food chain. Not surprisingly, considerable pressure is brought upon the police, including DS Logan McCrae, to solve the grisly crimes committed by "The Flesher." Little is know about him except that he wears a Margaret Thatcher mask,who is cunning as a fox and frighteningly deadly,and may not be the person who was convicted of crime some twenty years ago. But the story takes another twist when members of the original investigation start to dissapear, McRae realizes the case might not be clear cut as everyone thinks.

This an edge -of -your seat page turner is riveting and gruesome. I'm not sure how much of it I missed since it seems to be one of a series, and I'm not up to date. However, I enjoyed the way the plot developed and unfolded in a fairly realistic manner. With a rampaging and seemingly invincible serial killer, Flesh House is nearly as much thriller as mystery. The pages turn rapidly, the characters are engaging (though often human enough to be unlikable), the writing is sometimes witty and sometimes gritty, the police are often unheroic, and the good guys don't always win. The Scottish setting is enjoyable. It is so compelling, that you need to take a break in the reading to absorb all the action. The story is violent and bloody,some of the crimes are vicious and the author doesn't hold back on the details. But there is a plenty of dark humor,and a warmth to the portrayal of the police officers which lightens an otherwise grim tale. There are instances where he grabs the reader by the throat.
While I liked the writing style, the various plot lines never really connected. I mostly enjoyed it, but found the ending a little anti-climactic after everything building up to it.
The book is a must read for those who's got a penchant for blood,gore and the macabre. Read it for the surge of adrenaline.

DOC TALK : A rash solution

Vaishalee Kirane
Laser Surgeon, Trichologist, Dermatologist

The long hot summer months are here. Your skin which looked radiant during winter is now dull, blemished and oily. Also, one tends to develop different skin rashes and infections due to perspiration and heat. The best solution is to follow a regular skin regimen and diet to counter the harmful effects of the sun.
The first and most essential mantra for your skin during summer is: Moisturising. But what moisturiser should you choose? What is the frequency and amount to be applied? And what are the measures to keep rashes at bay? Read on for answers...

Cream allergy
Moisturizers usually do not have an adverse effect on the skin. It is always advisable to test the cream on a small patch behind the ear or on your elbow to rule out any skin reaction.
That is because during winter, the skin's natural oils solidify, but during summer the oil flows freely. The excessive oil may result in skin eruptions. The skin becomes dry, red and itchy. Hence most people need lighter moisturizers. Although oil free or water-based moisturizers are preferred during the hot summer months, it is important to know your skin's needs. A person may also get acne or rashes due to hormonal imbalance and other internal factors. Usually we recommend rose water to be used in the affected area, as it has a cooling effect. The next step is to find out the main cause of the acne and consult a doctor for the right medicines as opposed to self-medication.

Dryness, skin burn and sun tan
The other nagging problems which occur during these months are extreme dryness of the skin, skin burns and tans. Too much exposure to the sun may lead to dryness, irritation, redness. Eventually, the skin starts peeling. During the day, one should protect one's skin, even if one is indoors. Use a sunscreen to avoid excessive tanning and dryness. Normally, a sunscreen of SPF 30 works well with Indian skin. Sunblocks with titanium oxide, zinc oxide and avo benzone protect the skin from the UV rays of the sun. Also, it is always advisable to carry an aloe vera cream as it helps to combat dryness.

Heat boils and skin eruptions
Heat boils and fungal eruptions are a common ailment during this hot and humid season. One should use an anti-fungal powder which will be easily available at your nearest chemist store. Drinking plenty of water, juices and keeping yourself clean helps control the infection to a certain extent. Moreover, wearing loose, cotton clothes are a good option during this period.

Jewellery allergy
Most of us wear watches, hair clips, bracelets, rings and so on. But at times, after using these accessories, you may experience a furious itch, followed by a burning sensation and redness. This happens because you are allergic to a particular metal, and the heat and sweat aggravates the affected area. You should immediately remove the accessory and avoid contact with metal for a couple of weeks till the rash subsides. Avoid nickel-rich food like chocolates, beans, peas for a certain period, or till you are fine.
Above all, be kind to yourself, if your skin breaks out. Don't take matters in your own hands. Consult a dermatologist immediately.

- As told to Barnalee Handique