Firstly, one needs to understand that blood in a person’s stools could be from within the digestive tract (mainly bleeding in the rectum and anus or higher in the digestive tract like the colon). There could be a number of reasons for  bleeding within the digestive tract including:

1. Anal fissures: Is a cut or wound in the anus caused mainly due to passing hard stools, and in some rare cases due to frequent loose motions. The discerning characteristic of this condition is that the blood is usually bright red and is seen as either blood streaked stools or blood after the person has passed motion. Dr Malladi says, ‘ Fissures cause pain while passing motion. Patients describe it as a burning and pinching pain similar to when one gets cut or hurt repeatedly in the same place.’
2. Hemorrhoids or Piles: According to Dr Malladi  ‘The other common reason is piles, where there are certain blood vessels in the anal region that swell up, and then lead to bleeding. Within the digestive lining of the stomach there are a number of diverticuli or folds in the wall of the stomach. These walls are well supplied with blood vessels. In piles one section near the rectum or anus becomes swollen and ruptures leading to bleeding in the stool. In many people this is an intermittent problem and resolves itself.’ Patients with piles will generally not feel too much pain in the early stages. It is only when the condition worsens does the pain start. There are three degrees of piles. A first degree is where the swelling and bleeding is minimal. The second degree is where the piles temporarily protrude outside the anus, but retracts on its own. In the third degree or a prolapsed piles, it hangs outside the anus and does not retract.  To diagnose the extent of the condition a doctor will use something called a probe, with a camera fitted at the end. This helps the doctor look at the exact extent to which the disease has progressed.
3. Peptic ulcers: Basically holes in the digestive tract, they are caused by infection by bacteria like Helicobacter pylori or excessive production of stomach acids. Constant irritation to this area causes bleeding, which is then seen in stools. In the case of peptic ulcers, the blood may not be visible to the naked eye. In such a case your doctor may prescribe a test called the faecal occult, which identifies the presence of small amounts of blood in feces.  
4. Colitis: As the name indicates, it is an infection within the colon (part of the intestine). This leads to inflammation and bleeding once faeces passes through the region. Tarry stools along with abdominal pain and constipation are hallmarks of this condition. Often one might experience symptoms like incomplete evacuation or recurrent constipation.
5. Inflammatory bowel syndrome: This is a condition where the inner lining of the bowel (lower digestive tract) becomes inflamed (red and swollen). In some cases this may be due to an allergy or infection. Although the condition might get resolved on its own, when this condition becomes worse it leads to bleeding.
6. Diverticular disease: This is a condition that occurs most commonly in older people, or those that take laxatives regularly. Diverticulitis is a condition where the lining of the intestine gets infected, leading to bleeding. In such a case the patient will notice black or ‘tarry’ stools. This is because the excess acids change the color of the blood which then gets mixed with faeces.
7. Polyps: Are small outgrowths along the digestive tracts. They can be either cancerous or benign. Since these outgrowths are heavily laden with blood vessels, when they rupture, it leads to bleeding internally.
8. Stomach Cancer: Dr Malladi says, ‘Most people ignore bleeding in the stomach, but when it is associated with symptoms like severe abdominal pain, passing motion twice or lesser than that in a week, loss of appetite and mild nausea, the patient should immediately visit a physician.’ Stomach cancers are more common than most people might think, and detecting its presence early is extremely important for effective treatment.

The right diagnosis is key

Initially a doctor will assess the patient’s symptoms to decide what type of diagnostic techniques should be used. The patient might have to get a stool test done. While this can identify the presence of blood in stools, it cannot indicate the exact area of the bleed for which one may be asked to undergo tests where the doctor inserts a probe via the anus (colonoscopy) or the mouth. In some cases, the stomach contents of the patients are emptied and tested for the presence of blood. If the doctor suspects  peptic ulcer caused by infection, blood tests may be advised.

Treatment options vary as per the diagnosis

According to Dr Malladi, ‘Treatment for fissures is usually very simple and requires only medication. It can be easily cured and does not require surgery. In the case of piles, it is a common belief that a person with piles must have surgery. That is not at all true. Only once the doctor determines the extent to which the condition has progressed can he/she prescribes either a course of medication or surgery. It is very important to get a proper medical diagnosis in such cases.’

Lastly, Dr Malladi adds, ‘If you see blood in your stools, please make it a point to visit a good doctor who can correctly identify the cause of the bleed. Do not go to quacks or clinics that offer a painless remedy for piles because that can cause more trouble than good. Always remember that not all blood in stools is piles.’

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Arun is a 52-year-old energetic and a busy entrepreneur. With everything going his way, he has only one stumbling block – he suffers from diabetes. Although his wife keeps a watch on his diet and exercise routine, she worries about an emergency situation if Arun’s sugar level were to fall. Like Arun, there are a number of people who suffer from the disease. India is quickly becoming the diabetic capital of the world and with almost every household having one diabetic, it’s only wise that you know more about diabetic emergencies. We spoke to our expert Dr Rajiv Kovil, leading diabetologist, about what you should have at hand in the case of an emergency.

Dr Kovil says, ‘the three most common complications related to diabetes are  hypoglycaemia (low sugar), diabetic ketoacidosis (high blood sugar) and hyperosmolar non-ketotic coma, a condition where the person’s blood sugar goes above 600 units.

Again, in hypoglycaemia , there are basically three main types:

Mild hypoglycaemia is where the patient feels uneasiness, dizziness, excessive sweating etc. In such a case, all the person has to do is have an extra serving of some carbohydrates (candy, chocolate or fruit juice).

In the case of moderate hypoglycaemia, the patient experiences severe symptoms like excessive sweating, cold palms and feet, dizziness, palpitations, confusion, irritability, pale skin, trembling, weakness, anxiety, etc. In such a case, he/she will require someone to take care of him/her.  The best way to quickly raise the sugar level is to place sugar or honey under the patient’s tongue and immediately seek medical attention.

Severe hypoglycaemia is where the patient needs to be hospitalised for low sugar and treated accordingly. Symptoms include headache, poor coordination, severe confusion, fainting spells, numbness in the mouth and tongue and finally coma. In such a situation, the caretaker should immediately seek emergency medical attention.  

According to Dr Rajiv Kovil, ‘The red flag in the case of people suffering from hypoglycaemia is called the triad – display of classic symptoms, low glucose level and the indication that the person responds well after eating something sweet.’

The best way to help a patient out of a diabetic episode is to give him/her at least 15 grams, of any of the following foods:

• four to six pieces of hard candy
• half a cup of fruit juice with sugar
• half a cup of any soft drink (not the diet variety)
• one tablespoon of honey
• one tablespoon of sugar
• one tablespoon of corn starch
• one glucose tablet

Dr Kovil advises, ‘Moderate to severe hypoglycaemia should be assessed properly. Severe hypoglycaemia in elderly patients and those who suffer from hypoglycaemia unawareness (those who do not experience the symptoms of hypoglycaemia) require a thorough check up and identification of the possible risk factors. It is paramount to managing diabetes appropriately.’

The other two diabetic emergencies are due to high blood sugar. ‘High blood sugar leads to the  breakdown of fat cells and the formation of ketone or blood acids. This is an extremely dangerous condition which can lead to severe complications such as coma or death,’ says Dr Rajiv Kovil.

The symptoms of both the conditions are, excessive thirst, frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath and confusion. Both diabetic ketoacidosis and diabetic hyperosmolar non-ketotic coma are extremely serious conditions, which require immediate hospitalization. If a person is at risk of suffering from either of the two conditions, he/she can monitor their blood sugar levels and ketone levels in their urine through home test kits.

Lastly, Dr Kovil says, ‘It is important to realise that not all patients show similar symptoms. While some may show no symptoms at all, others might manifest the disease differently. In either case, it is essential to get regular check-ups from a good diabetologist. In case of patients who suffer from diabetic ketoacidosis or hyperosmolar  non-ketotic coma, their doctor must make it a point to check for other underlying conditions such as infections or malfunctions of organs.’

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According to the WHO (World Health Organisation),  one in three people world over suffer from high blood pressure*. With India forming a significant part of this statistic, it is time we took notice. This year’s theme for World Hypertension day is ‘Healthy Heart Beat-Healthy Blood Pressure’. In this post, we have tried to explain what the relation between the two is.

How are heartbeats connected to blood pressure?

When the heart beats, it acts like a pump that takes in de-oxygenated blood from the body, and pushes out oxygenated blood with great pressure. The pushing out of blood leads to  pressure being exerted by the blood on the blood vessels in the body. This is known as blood pressure. Although the workings of the heart are not that simple, the explanation shows that there is a direct correlation between  the number of heartbeats and blood pressure. In some cases the heart may beat at a normal rate, but due to other factors, like blocks in the blood vessels, irregularities of the valves within the heart etc, a person could suffer from high blood pressure. According to Dr Aashish Contractor, preventive cardiologist at the Asian Heart Institute, ‘Optimal blood pressure is below 120/80. A person can be diagnosed with high blood pressure if his/her BP is above 140/90. Anything in between is considered as borderline’.

Apart from this, some people might suffer from a condition called Atrial fibrillation or AF. Although this condition is not very common, people with this condition experience extremely irregular heartbeats, which then leads to high or low blood pressure, dizziness and in some cases can lead to a heart attack or stroke. It may have no symptoms and can only be detected by either checking the pulse, or by a healthcare professional. An episode of AF can lead to formation of blood clots, which may flow out of the heart and cause blocks in other blood vessels, leading to severe consequences strokes. AF episodes first start off intermittently and may become permanent in the long run.

Hypertension or high blood pressure is the most common risk factor that leads to AF. If both AF and hypertension coexist, it puts a person at higher risk of suffering from a stroke.

What is normal and what isn’t when it comes to heartbeats? 

According to Dr Aashish Contractor, ‘a normal heart rate consists of 60-90 heart beats per minute, when a person is at rest. Anything above or below this can be considered abnormal’. According to specialists, a heart rate that is higher than 100 to 150 beats is considered extremely dangerous. Symptoms usually range from feeling faint, uneasiness usually in the chest, fainting etc.

How does one detect any kind of abnormality in the heartbeats?

If a person feels that his/her heartbeat might be above or below normal, the best way to detect it is to simply measure his/her blood pressure and pulse rate. In the case of patients who are suffering from AF, their doctor will perform some simple tests to detect it. He/she may perform tests like an EKG (Electrocardiography), Holter test, Stress test, chest X-ray, and in some cases a blood test as well. All these tests are absolutely painless and non invasive in nature. If a doctor finds it difficult to detect the extent of the AF he may prescribe an Transoesophageal echocardiography (TEE). This is a test where the doctor will use a probe to check for irregular heartbeats through the oesophagus.

What are the treatment options for  irregular heartbeats?

There are basically two ways to control irregular heartbeats, they are – the rhythm control method  and rate control method.

The aim of the rhythm control method is to regularize  a person’s heartbeat. A doctor may primarily choose to treat a patient with medication, and if that fails, the patient might be given a controlled shock over the heart to regularize his/her  heart rate. Dr Contractor says , ‘All  procedures must be  strictly monitored by a trained professional, and should never be tried without supervision’.

The rate control method employs medication to slow the heart rate of a person. In most cases these medications also help to control irregular heart beats.

Lastly, remember that prevention is always better than cure, so get some exercise, eat healthy and get regular check ups to stay in shape. 

Source: * WHO

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What is this procedure? Why did she need to have it? How is the genetic testing for breast cancer done? Is it available in India? We answer some such questions in this post.

What is a preventive mastectomy and why is it needed?

Also known as prophylactic or risk reducing mastectomy, it involves removing both breasts in order to reduce the chances of breast cancer in the future. A preventive mastectomy is recommended for women who are at a very high risk of suffering from the disease. The risk factor for a woman is decided by certain tests that detect the genetic mutation within certain genes. In Angelina Jolie’s case, it was the BRCA1 gene. 

What is the BRCA1 gene?

There are two genes that make a woman susceptible to breast cancer – the BRCA1 and BRCA2 gene. The BRCA1 gene is a type of tumor suppressor gene. It is named the breast cancer, early onset gene and its main function is to repair damaged DNA. The gene is primarily found in the breast tissue and is largely responsible  for breast cancer, ovarian cancer and cervical cancer in women. The mutation of this gene results in a malformation or  broken DNA which then leads to the formation of a cancer.

How are these genes detected?

The BRCA gene test is an analysis of the DNA to identify any harmful mutations. These mutations are found either by a blood test or a bone marrow test and are recommended for people who are at risk of contracting a very specific type of breast cancer or ovarian cancer. Having the BRCA1 or BRCA2 gene mutation is fairly uncommon and has only about a 5 per cent chance of leading to breast cancer and 10 to 15 per cent chance of leading to ovarian cancer.**  After the test genetic counseling plays an important part in the testing process.

Are these tests available in India?

There are a few hospitals and diagnostic labs in India that can help with genetic testing for this trait. The forerunner of these centers is the Tata Memorial hospital, and other centers include testing labs like NutraGene, that provide genetic testing for various ailments including cancer.

According to our expert Dr Shah, ‘Genetic testing is a very sensitive issue. And the results of genetic testing can sometimes may need to be interpreted with extreme care, because any decision is going to affect the patient’s life as also that of the blood relatives. Knee jerk reactions are very common in India and people tend to decide on their own. No patient should ever go for any form of genetic testing directly, on their own. It is very essential that patients and relatives discuss the same with their oncologist, and preferably get a special genetic counselling first from a qualified genetic counsellor. Not all patients need genetic testing, criteria have been laid down as to which patients and their offsprings or sisters should undergo genetic testing. And the oncologist or the genetic Counsellor will guide them whether they need to undergo genetic testing or not. So I would suggest all readers to consult their oncologist about need of genetic testing and then decide about the same.’ 

Does the whole breast need to be removed for prophylactic mastectomies?

Though there are many different options available in cases where women are already suffering from breast cancer, in the case of preventive or prophylactic mastectomies, either a total mastectomy (entire breast tissue, areola, nipples and associated structures, lymph nodes in the armpit and the chest muscles are spared) or a nipple sparing mastectomy(tissue within the breast is removed, but the skin, chest muscles and the nipple are kept intact) is indicated.

What are the risks involved in a mastectomy?

If the surgery is performed well there are minimal associated risks. However, there are a few things that a woman should be prepared for - bleeding, infection, pain in the armpits and chest area, swelling around the arms, formation of scar tissue, shoulder pain, numbness around the surgical site etc.

According to our expert Dr Sumeet Shah, leading surgical oncologist,‘there are no side effects of the surgery as such. Swelling of the arm on the same side (due to surgery in the armpit, to remove the nodes) and cosmetic issues (psychological effects due to loss of the breast) are the only effects after mastectomy. Normally there are no hormonal changes seen, due to removal of the breasts.’

Is there any other treatment required after the surgery?

According to Dr Sumeet Shah, ‘A woman may be asked to undergo either chemotherapy or radiotherapy after a mastectomy, depending on the pathological reports after removal of the cancerous tissue’.  However, in cases of preventive mastectomies, no further treatments are required post surgery. 

While most people decide to opt for a mastectomy after being diagnosed with breast cancer, it takes a lot of courage to get the surgery done as a preventive measure. We at Health.India.com, laud the efforts of Angelina Jolie in taking a proactive stance against the disease. In the words of the actress, now her kids can live without the worry of losing their mother.

Statistical source: *http://www.breastcancerindia.net

                                   ** http://www.mayoclinic.com 

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Diarrhoea is a disease that is spread from one person to another due to infection from an organism. According to statistics, India falls behind the rest of the world because of the large number of people who do not have access to proper bathrooms which leads to open defecation, a practice common in rural parts of the country. According to the study performed by the Global Enteric Multicenter Study (GEMS), it was found that the most common diarrhoea causing virus is the rotavirus. This virus is mainly spread by the fecal-oral route. This means, that the virus spreads from one person to another when the food or water they consume is contaminated. The government roped in Vidya Balan to campaign against open defecation. 

According to UNICEF-WHO Joint Monitoring Programme Report 2010, nearly 60 percent of India’s 1.1 billion people still practice open defecation and close to 58 percent of all open defecation in the world is in India and the government is likely to spend Rs 150 milion to fight the problem.

While, this particular problem might not be the reason for urban kids suffering from diarrhoea, there a few things that parents should know in order to keep their child safe if he/she suffers from the disease. Apart from the rotavirus, there are a number of other organisms that can cause diarrhoea. Bacteria like Salmonella, Shigella, Campylobacter, and various forms of Escherichia coli , parasites like jade, Cryptosporidium and Entamoeba can be the causative agents in a number of cases. There are other things that could lead to diarrhoea in an infant, for example an allergy to certain foods like milk and soya . A fairly common condition seen is something called ‘toddlers’ diarrhoea’. This is where the child suffers from loose motions because he/she has had too much fluid. It leads to the digestive system getting overwhelmed by the amount of fluids and sugar leading to diarrhoea.  When a child has an infection that leads to diarrhoea, it is called gastroenteritis.

Why should you worry?

Diarrhoea, can be fatal to young children, mainly because they don’t have a well developed immune system to fight the disease, they do not have the skills to tell their caregivers what’s wrong and being very young they tend to get very easily dehydrated which could lead to death.

When should you worry?

In most cases diarrhoea will resolve  with time and home care, but it is essential to be vigilant when it comes to the child becoming dehydrated. The onset of dehydration can be very gradual if the child passes loose stool or urinates fairly infrequently, but if your child need to go to the bathroom very often  and is having watery stools, it is essential that you keep an eye out for signs of dehydration.

Here are a few symptoms of dehydration you should look out for:  

1. The child has dry lips and mouth
2. He/she asks for water frequently and drinks it readily
3. In babies, the top, soft part of the skull (fontanelle) is depressed
4. The child’s hands and feet are cold to touch – this is an indicator of bad circulation and needs immediate medical attention.
5. The eyes of the child are sunken in
6. The skin appears less elastic – a good way to test this is to pinch the skin, on top of the abdomen, and see if it bounced back normally, there is nothing to worry, but If it stays in the raised position it means the child is dehydrated.
7. The child has pale skin – press down with your thumb on the breastbone (bone found between the ribs, at the center of the chest) till the skin becomes white. Now let the skin go and count the amount of time it takes for the colour to return to normal. If it takes longer than 3 seconds, the child requires immediate medical attention.

Steps to avoid further infection

Since the bacteria and viruses that cause diarrhoea is spread very easily, remember to maintain proper hygiene when dealing with a sick child. Teach them to wash their hands well with soap after going to the bathroom, wash your hands well after changing a diaper or cleaning up after your kids. Make sure you wash your hands well before you start cooking to ensure that the bacteria is not passed on.

Vaccines

There is a way to keep your child safe from diarrhoea. Since the Rotavirus is the most rampant causative agent of the disease there are two vaccines that can protect your child. The Rota Teq and Rotarix vaccines are available worldwide and can be administered to children.

Dos and Don’ts:

• If your child suffers from diarrhoea, your number one priority should be to keep their level of their fluids up to ensure that he/she does not get dehydrated.
• Do not discontinue feeding your child milk. Continue to feed your child breast milk (if he/she is still breastfed) or milk as he/she is used to.
• A good way to keep dehydration at bay is to give them ORS (Oral rehydration solution. This mixture is readily available in the market. It contains salt, glucose and electrolytes that help to restore your child’s fluid levels.
• If you do not have access to ORS, you can make the solution at home. Just take one litre of water, add half a teaspoon of salt and 6 teaspoons of sugar to it. Mix well and give this solution to your child as often as possible. 
• Do not try to keep your child hydrated using artificial juices or colas. They contain a lot of sugar which could lead to further dehydration and further irritate the stomach.
• Do not give your child any medications to stop diarrhoea, these medications can be fatal in children.
• Do not start any antibiotics for your child without a doctor’s prescription.

Lastly, diarrhoea is a completely avoidable disease. All you need to do is keep a few simple tips in mind.

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In most women, a gynaecologist might incidentally notice the presence of fibroids during a routine sonography, since very few experience any noticeable symptoms. 

Most women experience symptoms only when the fibroid grows to such an extent that it presses on the uterus, rectum, bladder or spinal column. Another possible cause for the symptoms could be the fact that when the fibroid outgrows its blood supply and is deprived of nutrition, it begins to die and releases by-products that causes pain and fever. If you notice any of the following symptoms, consult a good gynecologist:

• Prolonged menstrual bleeding that lasts for more than seven days
• Persistent pelvic pain even after menstruation (when the fibroid is pressing on the uterus or the back)
• Frequent urination and difficulty emptying the bladder 
• Constipation (when the fibroid is present at the back of the uterus, exerting pressure on the rectum)
• Back or leg pain (when a fibroid either grows large and presses on the spinal column through the uterus or is formed behind the uterus)

A fibroid is formed from the smooth muscle tissues of the uterus and looks like a smooth, rubbery and pale mass that is distinct from the surrounding tissue.  

Renowned gynecologist Dr Hrishikesh Pai says, ‘The cause of fibroids  is not known completely, but it has been found that its growth depends on estrogen. They are known to grow continuously but steadily in menstruating women.’ It has been noticed that they tend to decrease in size once a woman reaches menopause because of the lowered production of estrogen during this period.  Certain research also shows that genetics and insulin-like growth factor can also cause fibroids.

Being overweight and delay in bearing children increase the risk of developing them too.

When you visit a gynecologist for the above symptoms, he/she will take a detailed history first, followed by a physical examination. A doctor may suggest more tests like a complete blood count (CBC) to check for the general health of the woman, a blood test to check for clotting factors and for the presence of any disease that may cause excessive bleeding, and finally a test to check for anaemia. An ultrasonography (USG) may be asked for to  assess the  exact size, type and location of the fibroid. Hysteroscopy (a small lighted telescope called a hysteroscopeis inserted through the vagina and cervix into the uterus to view it). If the patient has uncontrolled and heavy bleeding, a sonography may have to be administered while the hysteroscope is being used. Sometimes, a dye is used to highlight the Fallopian tubes and the wall of the uterus. An X-ray is then taken. This technique helps the doctor to not only detect the presence of fibroids but also to see if the Fallopian tubes are open.

There are a number of treatment options available . Dr. Hrishikesh Pai says, ‘The treatment of uterine fibroid depends on age, general health, type of fibroid(s), pregnancy status and the severity of the case.’

Usually, the treatment is started with medications containing hormones that are meant to modify the hormonal levels within the woman’s body and control symptoms such as heavy bleeding and pelvic pressure. These medications do not completely eradicate the tumor, but are known to shrink it in size. Doctors usually prescribe contraceptive pills first. A combination of estrogen and progesterone puts the woman in a temporary postmenopausal phase causing the fibroid to shrink, reducing excessive bleeding. It is usually prescribed right before a surgery to help the surgeon easily remove the tumor. A synthetic agent (Danazol) that mimics testosterone effectively stops bleeding and shrinks the tumor and uterus. However, it is not widely used as it has severe side effects such as nausea, depression, anxiety etc. Sometimes, an intrauterine device that releases Progestin may also be used.

When the medical methods do not work or if the fibroids are very large, a surgery may be required. According to Dr. Pai , ‘A hysterectomy is a great option for women with large fibroids, but only in cases where they do not wish to have more children. It is an operation where the surgeon will remove the entire uterus including the tumor. A minimally invasive form of a hysterectomy can be performed using laparoscopic technique. Women who want to have children can opt for a laparoscopic myomectomy. The major advantage is that it can preserve fertility and small incision is enough to do the surgery’.  

Other minimally invasive procedures include the focused ultrasound surgery (where high frequency sound waves are used to remove the fibroid), myolysis (a laproscopic procedure that uses laser to destroy the fibroid), endometrial ablation ( a procedure using heat and microwaves to remove the tumor), uterine artery embolisation (a procedure where a catheter delivers small particles that destroy the fibroid through the uterine artery).

 If untreated, fibroids can reduce the chances of getting pregnant. They may cause a distortion of the fallopian tubes leading to lack of ovulation, may block the entry of sperm into the uterus in the case of cervical fibroids and may cause disruptions in the implantation of the fetus in the case of submucosal fibroids.

In case a woman is already pregnant, fibroids can be quite dangerous. Complications during this phase include pain during the first and second trimester of the pregnancy. If a woman experiences multiple miscarriages or is unable to conceive after a year of trying, she should consult her gynecologist immediately.

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Imran Khan, fell from a height of approximately 15 feet, and hit his head on an iron rod, which lead to a severe laceration on his forehead. His fall was broken by two of his bodyguards who were standing beside him when the lift started its ascend. He was then rushed to the nearest hospital for emergent treatment.  

Doctors said that Imran Khan  had  suffered a broken cervical vertebrae (vertebrae of the neck) and two lumbar vertebrae (vertebrae of the back) along with a fractured rib when he fell. They also made it very clear that he had not sustained any serious head injuries as reported earlier. Expecting the worst, doctors expressed their awe when they found that the politician had sustained fairly manageable injuries even after such a severe fall. He  has been advised complete bed rest to allow for complete recuperation.          

When a person falls from such a great height they can suffer from severe complications like– broken vertebrae, fractured ribs, punctured lungs, a broken neck, severe injury to the skull which could lead to a skull fracture and internal hemorrhage of the brain, internal bleeding due to damaged organs, a broken femur or thigh bone (the femur is the strongest bone in the human body), a broken hip, puncture various internal organs due to bone shards puncturing them, the person might even get paralyzed if broken vertebrae cause damage to the spinal canal and spinal cord, and severe shock which can stop the heart leading to brain damage and death.  

In the case of Imran Khan, even though he broke three vertebrae, the fall did not cause any damage to the spinal canal. The spinal canal is the space between the vertebrae through which the spinal cord travels from the base of the skull to the tail bone (bones at the base of the spinal cord, which ends just above the buttocks). The vertebrae are bony structures that form the backbone. Apart from other functions it also acts as a protective shield for the very delicate spinal cord. An injury to the spinal cord can lead to paralysis of either the entire body or parts of the body depending on the area of the spinal cord injury.

According to the media footage Imran Khan was carried away by supporters from the scene. In the case of such severe injuries, being carried away without any support to the back and neck can worsen the damage already caused by the fall. While their actions may have saved the politician’s life, there are a few precautions one should take while dealing with such injuries.

Here are a few first aid tips in cases you encounter a situation like this:

If a person has fallen from a great height or has been grievously injured during an accident– first call for an ambulance. Do not move the person unless it is absolutely necessary to save their life. If you have to move the person, do so by keeping their head and neck absolutely immobile. Try to lift the person using a stretcher or a stiff board. This board will help to move the person’s entire body as one unit while allowing for minimum movement of his/her head and neck.

If the person is not moving, you may try performing CPR, but do not move the person’s head back while doing so, instead open their jaw by placing two fingers on his/her chin and push down. This will help to open the airway and help the person breathe. Transport the person to the nearest hospital as fast as possible.

In the case of Imran Khan, it is truly heart warming to see that he is doing well and on his way to a quick recovery. We at Health.india.com wish the cricketing legend a speedy recovery. 

Image courtesy: www.chiro.org

Preeti Rathi

A few years ago this request would have been impossible, but thanks to the latest advances in stem cell therapy it’s now a very feasible possibility. We talked to ophthalmologist Dr Yasmin Bhagat who has treated a number of acid attack victims and helped them regain vision using this procedure. Excerpts from the exclusive interview where she explains the procedure: 

At the offset, Dr Bhagat said that the media reports that she was planning to take stem cells from Rathi’s parent’s eyes were erroneous. She said that even though the acid had badly damaged Rathi’s right eye’s cornea, her left eye was still functioning well and that she would use stem cells from that eye.

Pavitra: Why did you decide to use cells from her left eye and not her parents’ eyes to start the treatment?

Dr Yasmin Bhagat: When we perform such a procedure, there are some risks involved. When we use the patient’s own cells we avoid the possibility of any complications that may arise from the rejection of the patch by the body. Even though the cells would be from her parents, there are chances that her body may reject it, therefore it is better to use her own stem cells.

Pavitra: How will this procedure work?

Dr Yasmin Bhagat: Within the eye there is a structure called the Limbus. The Limbus is a narrow zone between the cornea and bulbar conjunctiva, it is responsible for the renewal and repair of the cornea. Burns to this area causes the malfunctioning of the limbus leading to limbal stem-cell deficiency. When the limbus is damaged or malfunctions, instead of helping repair the cornea, it causes the formation of scar tissue, which leads to blurred vision and in extreme cases — blindness. In the case of Preeti, her left eye is completely normal, so we will take limbus cells from her left eye and culture them in a lab. By culture I mean we will grow the cells  to multiply them. We will then place a 2×2 mm patch of these cultured  stem cells on the damaged area of the eye, which will help the right eye repair itself.

Pavitra: How long will this procedure take?

Dr Yasmin Bhagat: Well, Preeti has to fully recover from her other injuries for us to start the procedure. The harvest and culture of the limbus stem cells alone, will take approximately 15 days after which we can place it on the right eye. Thereafter the recovery time usually depends on the patient’s all-round health. This is a complex procedure and it is necessary to be extremely careful while performing it.

Lastly, while Preeti recuperates in the hospital, she has received immense support from people all over the country. We at Health.india.com wish her a speedy recovery.

May 7 is World Asthma Day.

Suffocation, a feeling that most of us fear is a common occurrence in the lives of people suffering from asthma. With the diseases debilitating the lives of many in our country, it is time we took control. Here are 10 facts about asthma you should know:

1.  Asthma is a condition where a person finds it difficult to breathe because the tubes  that take air into the lungs swell up, making it difficult to breathe. This reaction is caused because the airway comes in contact with an asthma trigger (an allergen) that causes it to swell up.

2. At present 25% of the Indian population suffers from allergies and 5% of those people suffer from allergies that lead to asthma*. Although the exact percentage of people suffering from the disease is unknown, it is estimated that by the year 2025 an additional 100 million people will be asthmatic world over**.

3. Common symptoms of asthma are coughing which gets worse at night, wheezing (a whistling sound from the chest when the person breathes), chest tightness and shortness of breath.

4. There are two types of asthma, depending on the type of trigger – extrinsic and intrinsic asthma. Extrinsic asthma is an immune response to an external allergen such as pollen, animal dander, dust etc. Intrinsic asthma is caused due to inhaling certain chemical agents such as cigarette smoke, paint vapours, etc. In some cases it may also be worsened by a chest infection, stress, laughter etc. Some drugs like aspirin and other NSAIDs are also known to cause asthma attacks.

5.The most common allergens that cause asthma are pollen, dust, pollution like smoke from vehicles, animal dander, certain smells like that of diesel and petrol combustion, peeling paint and fungus or mould in enclosed areas. There are mainly two types of reactions a delayed hypersensitive response (where the person experiences symptoms after a long period of time) and an instant hypersensitive response ( where the person immediately develops symptoms to the allergen) .

6. A person can develop asthma at any age, and some researchers believe that it may even be a genetically inherited trait. Young children can suffer from mild asthma, which usually progresses to a more severe form later in life. Research has shown that exposure to environmental allergens combined with airway obstructions at an early age, can lead to severe asthma in adulthood. In rare cases some women suffer from adult-onset asthma. This is a condition that is not only specific to women , but is seen largely in them due to fluctuating levels of the hormone oestrogen. Doctors have found that women going through either emotional stress or menopause, experience peaks of estrogen levels in their body which leads to the swelling up of the airways leading to sudden and severe asthma attacks. This phenomenon can occurs in women who have never had asthma all their lives.

7. There are a number of ways to treat the symptoms of asthma – allopathic and natural remedies. In the allopathic method the most effective way to treat asthma is to use inhaled medication. There are two types of medicines available — relievers and preventers. Relievers are used in cases of emergency, and are quick acting agents. They are inhaled and help the surrounding muscle relax, allowing the person to breath normally again. Preventers are steroid-based medicines that help asthmatics by reducing the sensitivity of their airways to allergens. They are slow acting and help reduce the number of asthma attacks a person has. Preventers contain corticosteroids. Most people believe that taking steroids can be harmful to the body, but that is not always true. Unlike other steroid-based medications, preventers are inhaled directly into the lungs, thereby allowing very little of the steroid into the body itself.

8. Apart from the traditional inhalers, there are steroid-based tablets that one can take to control asthma. These tablets usually take longer to react in case of an emergency since they are ingested and not inhaled.  Havingsteroid based tablets to control asthma gives the patient a 50 times greater dose of corticosteroids. Long term use of tablets have serious side effects such as osteoporosis, diabetes, bruising easily, cataract, heart burn and acidity.

9.It is a common myth that a person cannot die because of asthma that is not true. According to the WHO of the 300 million people who suffer  from asthma 25,000 of them died due to the disorder in 2005**.

10. Asthma can be prevented. Some of the most common methods is to first identify the causative agent of the asthma. The next step is to follow a desensitization pattern. This means helping the body slowly reduce its sensitivity to the particular allergen with controlled exposure to it.  Another way to prevent the disease is to make a few lifestyle changes, like maintaining a healthy lifestyle with a healthy diet and some form of exercise. Lastly, it is important for a patient to follow their doctor’s instructions regarding schedule regarding medication and regular checkups.

 *Source: Asthma Society of India

** Source: South Asia network for chronic disease, New Delhi

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The only clause it has is that the patient should avail treatment in either a government hospital or an institute recognized by the government. Another option for patients is that they may choose to be treated in centres recognized by the QCI (Quality Council of India) or NABH (National Accreditation Board of Health) or any other suitable institution.

Dr GS Lavekar, senior consultant and former DG at the department of AYUSH, says that in the previous years the inclusion of Ayurveda, Homeopathy and other forms ofmedicine  into the health insurance policies was impossible, but today, the IRDA has recognized the potential of these types of treatment modalities. He further added that this result is an outcome of a joint effort taken by the industry, the Ministry of Health and Department of AYUSH, especially by the then secretary of the department, S Jalja.  

Though the industry is very happy, insiders feel that the inclusion may take some time to be added into the current insurance covers as the medical and insurance companies might not want the inclusion to be made.  Prabodh Shah, president, Gujarat Ayurvedic Aushadh Manufacturers Association (GAAMA), said, ‘This is a great news for us, especially since more and more patients now will be able to take the benefit of Ayurvedic treatment, giving more credibility and recognition to our industry. But at the same time, we fear that the insurance company will take their own time in adopting this regulation creating problems for us.’

Although practitioners feel that including the AYUSH system of medication into insurance policies may take a bit of time, there are a few companies that have already taken a step towards implementing the new inclusion. Companies like  National Insurance Company, Star Health and Allied Insurance, L&T General Insurance have already started offering insurance cover for patients wishing to get treated under  AYUSH . Click here to read more about the hospitals that will offer this service.

 Health.India.com view:

The new inclusion may be the best thing that has happened to health insurance policy holders in a long time. Being able to avail of treatment under alternative medical practices could be a boon for many. It has been seen in a number of cases that those ailments that usually require surgery or some other drastic intervention under the allopathic method, are cured almost painlessly by alternate systems of medicine.  With all the positives outlined in this policy, there are a few drawbacks as well. For starters, finding an AYUSH hospital or center that is QCI or NABH accredited is going to be tough for the common man. Secondly, a number of government hospitals do have functioning Ayurveda and homeopathy centers, but what quality of care can the consumer hope for? Lastly, there are a number of centers that are highly recognized for providing exemplary treatment but are not accredited by any of the mentioned bodies. Will this inclusion in the mediclaim policies see a sudden increase in the number of requests to be recognized by the NABH? All in all this inclusion is a welcome change in insurance policies, but how much and how quickly will this change really help the common man, is yet to be seen.