By conservative estimates, one out of every 10 child suffers from a Urinary Tract Infection (UTI). The problem with this condition is it can often be confused with irritable bladder syndrome or sometimes doesn’t get detected at all. In severe cases, it can affect the kidney as well (pyelonephritis) leading to lifelong issues like hypertension. Dr Pankaj Deshpande, a paediatric nephrologist tells us more about the disease, its symptoms and why parents should take this condition very seriously.

Urinary Tract Infections (UTI) can be divided into two broad categories depending on the part of the urinary bladder it affects. When it affects the lower urinary tract it is known as cystitis and when it affects the upper urinary tract including the kidney it is known as pyelonephritis.

Detection

While older children might be able to voice his/her concerns like pain in the abdominal region, increased urine passing and loss of bladder control, detecting UTIs in younger children is particularly troublesome. The one symptom you need to look out for in very young children is fever without any accompanying cough or cold; that’s one of the clear signs. Because of the asymptomatic nature of the condition it’s very important to maintain constant vigilance.

Common causes

Children tend to suffer from UTIs either because they’re not drinking enough water or lack proper hygiene. Those who retain urine do so because they’re constipated which occurs because they are not drinking enough fluids leading to the condition. Basically, this vicious circle will continue until children start drinking enough fluids. The old adage of eight glasses of water might be too much for children, ideally, a child who weight 10-15 kg should drink at least 1 litre of fluids a day. There are other factors like genetic make-up but 90% of all UTIs can be prevented by simply drinking enough water and passing urine regularly. It’s up to the parent to set an example and make sure the children are drinking enough water.

Misconceptions

There’s a common belief that you can get infections from dirty toilets or diapers but the fact is that there’s no research to prove this. There might be a causal link in the sense that a dirty toilet could prevent a child from using it and lead to a UTI.  Diapers on the other hand can lead to rashes which can get confused with an infection. 

Complications

Like I mentioned before, the infection can be broadly categorised into two categories  based on the area it affects – lower tract infection and upper tract infection which includes the kidney. The second kind, known as pyelonephritis can lead to permanent kidney damage and dysfunction. The kidney of course plays a vital role regulating water and mineral levels and removing waste products through urine. Damage or dysfunction could manifest itself into lifestyle conditions like hypertension/ high blood pressure.

Treatment

The only way to treat UTI is through antibiotics. However, we have to make sure that the child is actually suffering from an infection and not carrying any other symptom like redness of the genital area or rashes because then they’d be given antibiotics without cause.

 Basically, the simplest way to avoid UTIs in children is by making sure they are drinking enough water, passing urine regularly and maintaining proper hygiene. 

At its worst, depression can be a frightening, debilitating condition. Millions of people around the world live with depression. Many of these individuals and their families are afraid to talk about their struggles, and don’t know where to turn for help. However, depression is largely preventable and treatable. Recognizing depression and seeking help is the first and most critical towards recovery. 

In collaboration with WHO to mark World Mental Health Day, writer and illustrator Matthew Johnstone tells the story of overcoming the “black dog of depression”.

Content Courtesy: WHO

Another reason is increased instances of smoking and drinking – two habits that are horrible for cardiovascular health. Other factors like increased use of oral contraceptives, irregular meal-times, tendency to eat junk food and lack of exercise are all taking a toll as well. All these lifestyle modifications make women more susceptible to heart disease.

Signs and symptoms of a heart attack in women

Women don’t experience the ‘classic’ symptoms of a heart attack. Some common symptoms in women are: 

• Uncomfortable pressure, squeezing, fullness or pain in the centre of your chest. These pains are infrequent and come and go.
• Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs such as breaking out in a cold sweat, nausea or light-headedness.
• As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

World AIDS Day is December 1. 

TeachAIDS has been universally feted for producing HIV/AIDS material that bypass the stigma of the disease and sex and provide life-saving tips. It has proved to be one of the most anti-HIV teaching aids and was adopted by the National AIDS Control Organisation as well. In this video, Bollywood actors Shabana Azmi and Shruti Hasan lend their voices to a TeachAIDS video that explains everything about HIV-AIDS. Starting from how the immune system works, how the virus attacks the immune system, how HIV develops into AIDS, how the virus can or can’t spread from person to person, symptoms and basically everything else associated with the disease.

 TeachAIDS is a non-profit organization that develops HIV prevention education technology materials. It is based on research done at Stanford University and is often considered a model health intervention technique. Since it bypasses stigma, it allows HIV prevention education in communities where sex is considered a taboo subject. TeachAIDS’ animations are used in more than 30 countries.

 Its materials are made available for free and funded through donations from individuals and organizations including Covington & Burling, Google, Nimmagadda Foundation, UNICEF, and Yahoo!.

Numerous international actors, musicians, and celebrities have lent their voices and representation to the TeachAIDS videos. These include notable actors and celebrities like Nagarjuna Akkineni, Amala Akkineni, Shabana Azmi, Shruti Haasan, Jayanthi, Prashanta Nanda, Navdeep, Amol Palekar, Anu Prabhakar, Swati Reddy, Anushka Shetty, Sudeep, Zeus and many others.

TeachAIDS Website

How to choose make-up for your skin type?

Choosing the right kind of cosmetics for your skin type is very important, especially for those who have oily and acne prone skin. There are lot of ingredients in make-up which can cause acne and are known as comedogenic substances. If you have acne prone or oily skin, always use a dry compact or compact cum foundation. Avoid a lotion or cream based foundation and use oil-free or water-based ones. Avoid cosmetics with lanolin or cocoa butter which stimulate and cause newer acne on the skin. Look for hydrating agents like Vitamin E or hyaluronic acid which hydrate the skin and at the same time keep the oil under control.

Are there any make-up products that people with acne should avoid?

People with acne should avoid cream based or lotion based products because they are very oily and don’t get off from the skin easily. They should avoid products containing preservatives like sesame oil or almond oil, and also certain cosmetics that contain red dye which stimulates acne. 

How should one ideally remove make-up?

Firstly, you need to wash your face with a cleanser. It will remove part of your superficial make-up. Use a make-up remover for long stay make-up. Make-up remover is not skin specific. Take it on the cotton and wipe your eyes, lips and/or cheeks. If you don’t want to use a make-up remover, use a baby oil raw milk to remove make-up. For dry or normal skin you can dab a little nourishing cream so that the skin starts breathing again after the make-up is removed. 

So go ahead and look gorgeous! Just choose the right make-up products. 

Dr Haresh Asnani, a retina specialist from Advanced Eye Hospital and Institute, Navi Mumbaitells us about its symptoms, causes, prevention and more.

What is the retina? How does it help us see?

The retina is like a camera. The light entering through the cornea of eye is focussed by the lens onto the retina. So retina is the layer which acts like the film in the camera. In short, it is the transparent layer right at the back of the eye. Retina contains light sensitive cells known as photoreceptors which receive the light and transmit this information to brain through optic nerves. The brain interprets this as a picture.

What are the common problems in the retina?

The common problems seen in the retina are diabetic retinopathy, age related macular degeneration, retinal vein occlusion (common in patients with high blood pressure), retinal detachment, retinal holes and tears, injuries to the eye involving retina, common problems of retina in children associated with genetic disorders and retinopathy of prematurity. Diabetic retinopathy is one of the most common retinal disorders that we treat now-a-days. As we know, India is the capital of diabetes of the world and some of the eye-related diabetes complications include retinopathy, nephropathy, and neuropathy.

In diabetic retinopathy retina receives less blood supply, a condition called hypoxia. Because of hypoxia the earliest changes seen are swelling and blood clots on the retina. These changes are called non-proliferative or background diabetic retinopathy. In advanced diabetic retinopathy there is increased blood clots and swelling affecting the patient’s vision. Diabetic maculopathy involves the centre of retina. The patient’s vision can get affected in the earliest stages of retinal maculopathy. If untreated, these conditions can progress into proliferative diabetic retinopathy, a condition in which there is bleeding from the retina (vitreous or pre-retinal haemorrhage) and blood vessels growing from the surface of retina invade the front part of the eye. This can be a very dangerous and fast progressing condition which requires surgical intervention in most of the cases. If not treated, it leads to end stage of diabetic retinopathy which is known as neo-vascular glaucoma. In this condition the intraocular (eye) pressure goes up due to blood vessels invading front part of the eye resulting in painful blind eye.

How do you diagnose these conditions?

In the early stages of diabetic retinopathy there are no symptoms. Few blood clots may be seen on the retinal surface. As retinopathy advances or diabetic maculopathy starts, a patient’s vision goes down. When there is bleeding from the retina, patients experience floaters i.e. a shower of black spots in front of the eye. When the proliferative stage starts, the blood vessels pull the retina leading to retinal tears and sudden loss of vision. There is a certain amount of pressure in the eye which maintains the eyeball in its shape and also plays a role in blood circulation in the eye. The normal intraocular pressure is 17-20 mm Hg. If it goes above that it starts pressing on the optic nerve and retinal nerve fibre layer and cause gradual loss of vision. End stage diabetic retinopathy results in unbearable pain due to rise in intraocular pressure.

Diagnosis of diabetic retinopathy has to be done at the earliest stage possible. After being screened for diabetes, the patient should have a baseline retina check-up. The tests done are optical coherence tomography (OCT) which shows thickness in the centre of retina and flourescein angiography which shows circulation of retina.

What are the treatments?

Intravitreal steroid injections or anti-vascular endothelial growth factor injections are given to control diabetic maculopathy. In early stages of retinopathy when there is ischemia (lack of blood) of retina, laser treatment is used. In later stages surgical procedure called vitrectomy (removing the blood clot filled vitreous from the centre of the eye) is done and then the retina is treated with laser. Then a gas or silicon oil is injected as a substitute to the vitreous into centre of the eye. Sometimes injections are combined with surgery when there is excessive bleeding in retina.

The single most important thing you can do to prevent long-term complications of diabetes is controlling your blood sugar. Keep an ideal body weight and an active lifestyle. Have a balanced diet, increase your level of physical activity and maintain a healthy weight to stay healthier longer and reduce your risk of developing complications of diabetes.

 What to do when someone has a heart attack?

Dr Vijay Surase: If a person is having chest pain, even if there’s a chance that he’s not suffering from a heart attack he deserves the benefit of doubt. The first step is to help the patient relax. Loosen their clothes and open the windows. Next pop a tablet of aspirin into their mouth. Don’t give it to them with water. Ask them to chew it instead. If that’s not possible crush the tablet in a little water and give it to them. Another medicine you can use is sorbitrate. Place the tablet under their tongue. You can give up to three sorbitrates in five minutes. They both have anti-coagulant properties; they help dissolve blood clots. However DO NOT GIVE sorbitrate to people who have low blood pressure or/and are sweating profusely.

Also you shouldn’t let them lie down flat. Ask them to either recline on a sofa or sit upright. Another thing you can do is ask them to cough out. This helps ventilate their lungs. A heart attack victim should be taken to the hospital as soon as possible, at least within one hour. During a heart attack, the heart stops pumping blood and this can damage the organs. Like a stroke, a heart attack has a golden period during which recovery is faster.

Quick tips for heart attack patients

• Never neglect a person with chest pain
• Make the person sit in a slightly reclined position
• Move the person to a more ventilated area
• Administer aspirin or sorbitrate
• If person is sweating profusely or pulse is low do not administer sorbitrate
• Ask the person to cough
• Seek immediate medical attention
• A person suffering from a heart attack should receive medical care within one hour.

Also read: Warning signs of a heart attack

There’s a common misconception that moisturizer should only be used by people who have dry skins. The truth is everyone needs to use them. Here’s what dermatologist Dr Ruchi Agarwal has to say about moisturizers:

Should moisturizers be used by all skin types?

Dr Ruchi Agarwal: Moisturizers should definitely be used by all skin types. When we talk about moisturizers somebody who has normal to dry skin would need a slightly stronger moisturizer and somebody with a combination or an oily skin needs a water-based and very mild moisturizer. So one could always check the content and see for a water-based moisturizer or a gel-based moisturizer, especially for oily skin.

Moisturizing tips for different skin types

You need moisturizer for all skin types. Dry skin often demands plenty of cleansing and regular skin cell stimulation. Opt for moisturizers and lotions that contain essential oils and preferably vitamin A, C, D & E.  Petroleum jelly contains the most oil, which makes them a smart choice for really dry skin. Make it a habit of applying moisturizer before retiring to bed. Indulge in milk bath once in a while to experience the goodness of milk and its moisturizing ability. 

It’s a myth that if you have oily skin you can skip the moisturizer. It sounds a little crazy to apply moisturizer to oily skin, but you need to replace the moisture on your skin that gets removed during cleansing. If you deprive your skin of moisture, your oil glands overproduce oil to compensate, making your skin more acne-prone. So it’s important to keep your skin’s moisture level balanced. Simply follow a washing-toning-moisturizing regime. Use lukewarm water to wash your face because it dissolves the oil more effectively than cold water and use soap. Unclog the pores by using astringents. Use water-based moisturizer to prevent your skin from getting dry without adding oil on it. Most people believe that ageing of the skin is inevitable and do not care much.

Many women these days are so concerned with anti-aging products they often overlook the power of a simple moisturizer. Skin that is moist simply looks better, so lines and creases are far less noticeable.

 How exactly do moisturizers help?

Moisturizers hold water in the outermost layer of skin (stratum corneum). They help treat your skin when it’s dry and prevent it from drying out again. They also protect your skin from harmful elements in the environment. Main ingredients in moisturizing products are often humectants and emollients. Humectants work by absorbing water from the air around you. Some e.g. are urea, glycerin and alpha hydroxy acids. Emollients like lanolin, petrolatum or mineral oil smooth the appearance of rough skin by filling in spaces between skin cells. Emollients can be oil-based or water-based. Most moisturizers have animal-based additives such as milk protein, beeswax and animal fat. Vegan products contain synthetic moisturizers or vegetable glycerine. Other ingredients that may be included in moisturizers are preservatives, plant extracts, vitamins, minerals and fragrances.

Many people with oily skin also have acne. Treatments for acne can often dry out skin. Noncomedogenic moisturizers are less likely to cause acne breakouts as they don’t clog pores. Protective moisturizers often contain emollients, antioxidants and sunscreens. Antioxidants fight free radicals that occur from sun exposure and pollution. Free radicals can destroy skin’s collagen. There are some specialized moisturizers which can help fight wrinkles, fade stretch marks or fake a sun tan. The most common being anti-aging cream which typically contain collagen and elastin; proteins that help keep your skin toned and flexible. Moisturizers that claim to get rid of stretch marks have not been shown to be very effective. There are also skin-darkening moisturizers that give you a summer glow without exposing yourself to the sun’s harmful UV rays!

 So whatever you do don’t forget that moisturizer. 

So what are the common signs of a heart attack?

Dr Vijay Surase: No one is immune to heart attacks – even people in their 20s and 30s.  If you are aware of this, it becomes easy to diagnose heart problems. People have trouble recognising the symptoms, around 25% patients turn up worried that they have a heart attack. Here are some of the warning signs of heart attacks you’ve to look out for:

• Discomfort or pain arising at the centre of chest.
• Feeling of suffocation with chest pain
• Difficulty in breathing

Some women and people with diabetes do not have classic symptoms. Women usually have no severe chest pain, but a general weakness and discomfort. This leads to women ignoring the problem until late. Most diabetics develop atypical symptoms like profuse sweating or loss of consciousness during a heart attack which may be misinterpreted as symptoms of low sugar in the body. Sometimes heart attack is diagnosed during investigations like ECG or echocardiography even though you may not have had any history of chest pain. Such silent heart problems are a major challenge because they progress rapidly towards heart failure.

Other signs and symptoms of a heart attack include:

• Anxiety
• Cough
• Fainting
• Light-headedness, dizziness
• Nausea or vomiting
• Palpitations (feeling like your heart is beating too fast or irregularly)
• Shortness of breath
• Sweating, which may be very heavy

Women too have to be on the watch out because they don’t experience the ‘classic’ symptoms of a heart attack. Some common symptoms in women are: 

• Uncomfortable pressure, squeezing, fullness or pain in the centre of your chest. These pains are infrequent and come and go.
• Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs such as breaking out in a cold sweat, nausea or light-headedness.
• As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Dietary advice for diabetics

Dr Shilpa Mittal:

Over the last few years I have seen a tremendous increase in the number of diabetics. Whenever I suggest a diet to diabetics I have to keep in mind a variety of things – are they taking insulin, their lifestyle, the amount of exercise they get and other such factors. What people, especially diabetics need to understand is that it’s not just what we eat but what time we eat it. It’s very important to space out meals. Instead of large meals, people should eat five small meals a day. Another very important thing is to consume enough carbohydrates. Carbs in fact are very important for diabetics because it gives them control over their blood sugar levels. Most diabetics should eat complex carbs like whole wheat breads and brown rice because along with providing enough energy they don’t increase people’s blood sugar levels. Another thing I’ve noticed is most diabetics tend to be overweight or obese. It’s very important to have a dietary regime that allows weight loss. The need to get enough exercise because that helps keep their blood sugar levels in check. 

Quick tips for diabetics

• Eat smaller meals
• Eat more complex carbs
• Overweight diabetics need a dietary regime which allows weight loss
• Regular exercise helps the regulation of sugar levels and insulin.

Also read: Food items that can keep diabetes at bay