About Dr Darshana Salve

Dr. Darshana Salve is a qualified general practitioner with special interest in lifestyle and family medicine. With years of experience in hospitals in Mumbai, she has come to believe in treating the person in a holistic way rather than just treating the symptoms of the disease/illness. For her, health is a state of complete physical, mental & social well being and not merely the absence of the disease. She also has the experience of conducting health camps for NGOs in the rural villages. She keeps herself active by going for regular walks, climbing stairs wherever possible, eating healthy and getting sound sleep. She firmly believes "Preservation of health is easier than the cure of the disease".

August 4, 2023 By Dr Darshana Salve 2 Comments

Tired All The Time? Here’s What’s Causing It!

The alarm is set for 6 am to go for a morning walk, filled with determination to start on a routine walk from the next morning, she went to sleep early. But, like any other day, the alarm went off, but as usual, she couldn’t get out of bed. With each passing day, it got difficult to even get up for work. This happened almost for 2-3 months when Ananya realized this was not just laziness but something beyond and decided to see a doctor. Ananya described that she had no energy to wake up in the morning and felt tired and exhausted by the end of the day. Sounds familiar? Yes! This happens to many around us or even to us. This syndrome is called Fatigue.

What is Fatigue?

Fatigue is generally defined as a feeling of lack of energy and motivation that can be physical, mental or both. Fatigue is very common. Fatigue can be caused by Physical (around 60%) as well as Mental causes (40%). Unfortunately, it can also occur in normal individuals who experience intense physical or mental activity (or both).

However, in contrast to fatigue that occurs with some diseases and syndromes, normal fatigue in healthy individuals is quickly relieved in few hours to about a day when the physical or mental activity is reduced and adequate rest is taken.

What Causes It?

Sleep Problems: Sleep Apnea, insomnia, working in shifts or work shift changes, pregnancy, extra night hours at “work”, gadget time, etc. can cause fatigue. For such problems, including foods like nuts or milk that are rich in tryptophan (sleep inducing hormone) can help get better sleep.
Dysglycemia: Skipping breakfast, long gaps between meals is known to cause irregular fluctuations in sugar levels. To avoid such irregularities one must have a healthy breakfast every day preferably within one hour of waking up. Always plan for a mid-meal snack especially when the gap exceeds 5 hours.
Nutritional Deficiency: Eating a healthy, balanced diet (proteins, carbohydrates, fats and fiber) is an important part of maintaining good health. It can help you feel your best. Include fruits, whole grains, and protein rich foods and avoid junk food, processed/packaged food.
Gut Disturbances: An acidic body doesn’t allow oxygen to be absorbed and in turn causes fatigue. Gastric issues such as bloating, constipation, food sensitivity/allergy, leaky gut (gastric reflux) all create havoc in our body resulting in physical and mental fatigue. Including adequate quantity of fiber, probiotics like curd and a good intake of water keep your gut happy and healthy.
Caffeine Overload: Limit tea/coffee/green tea to 2 cups/day. Avoid having it post sunset and near bed time.
Dehydration: When dehydrated, the fluid loss causes a drop in blood volume, which makes the heart work harder to push oxygen and nutrients through the bloodstream to the brain, skin, and muscles. Maintaining a water intake to 2.5-3 litre is adequate for the majority of the population.
Metabolic/Endocrine causes: Vitamin D deficiency, Hypothyroidism, Diabetes, Electrolyte abnormalities, kidney disease, Liver disease can all cause varying degrees of fatigue.
Anemia (Iron deficiency, Vitamin B12 deficiency): It is one of the most common reasons of fatigue or tiredness in India and especially common among women.
Infectious Diseases: Viral infections, Hepatitis, Tuberculosis, cytomegalovirus (CMV), HIV infection, Influenza (flu), Malaria and many other infectious diseases can cause fatigue.
Medications: It might come as a surprise to you but many drugs like antidepressants, anti-anxiety medications, sedatives, antihistamines, steroids and even some blood pressure medications can cause fatigue.
Mental Health: Stress, Depression, Anxiety, Drug abuse, Alcohol abuse, eating disorders, (for example bulimia/anorexia), Grief and Bereavement are all few of the most ignored causes of fatigue. Awareness and proactive management of mental disorders is a must for living healthy.

Depending on the above reasons, the right treatment must be decided as it is important that the root cause of fatigue be treated and not just the symptom.

In the case of Ananya, on taking a proper history and some blood tests, she was found to have nutritional and Vitamin D deficiency. Once these were corrected she felt strong and active enough to start with her healthy regime.

Fatigue is a natural part of our lives, because of which we tend to ignore it and instead learn to live with it. This causes more trouble in the long run. We must look out for tell-tale signs of things we could do earlier but can’t do anymore, unrelated aches and pains or headaches and if found positive we must seek the right help. Don’t let feeling tired today ruin your attempt to feel healthy tomorrow!

If you’re looking to relax, meditate or practice yoga to ward off fatigue, ask your GOQii Coach directly by subscribing for Personalised Health Coaching here.

#BeTheForce

December 13, 2018 By Dr Darshana Salve 8 Comments

Nail matters!

Every second person is eagerly waiting for rains so that we get relief from this scorching heat. But, as we welcome monsoon, it brings along with it hub of infections too. Monsoons play a perfect breeding ground for all vector- borne, viruses, fungus and parasites.

Humidity in air and excessive sweating tends to favor fungus to grow and multiply at a rapid rate. Fungus needs moisture and warmth, and monsoon provides it a conducive atmosphere to thrive and multiply.

Types of fungal infection:

Tinea Cruris / Ringworm
Candidiasis
Fungal Infection of Nails (Onychomycosis)
Tinea Alba (Pityriasis Alba)
Tinea Versicolor (Pityriasis Versicolor)
Pityriiasis Rosea

Out of the above list, fungal infection of nails aka Onychomycosisis the most neglected one.

Onychomycosis is a fungal infection of the nails that causes discoloration, thickening, and separation from the nail bed with/without foul smell. Onychomycosis occurs in 10% of the general population, 20% of persons older than 60 years. It is caused by a variety of organisms, but most cases are caused by dermatophytes. The risk of onychomycosis is 1.9 to 2.8 times higher in persons with diabetes compared with the general population. Onychomycosis affects toenails more often than fingernails because of their slower growth, reduced blood supply, and frequent confinement in dark, moist environments (eg- shoes).

Treatment:

Antifungals medicines are widely used for the treatment of onychomycosis. Treatment of Onychomycosis is widely believed to be only a cosmetic problem, but it can be uncomfortable and can lead to cellulitis (bacterial infection involving the inner layers of the skin) in older adults and foot ulcers in patients with diabetes. Eradication of the infection is a key to improving appearance and avoiding these complications, but it is not easily accomplished because nails are made of keratin, which is nonvascular and impermeable to many agents. Because of poor drug delivery to nails, results of treatment may not be apparent for a year.

Tea tree oil is a natural disinfectant, possessing fungicidal and anti-bacterial properties that make it popular in treating toenail fungus. 1 teaspoon of tea tree oil + 1/2 teaspoon of olive oil. Apply this mixture with the help of the cotton ball to the affected nail 2 times daily or add 4-5 drops of tea tree oil in enough water to soak your feet for 15-20 minutes.

Rub Coconut oil onto the area and let it absorb and dry naturally. Repeat 2-3 times daily. Wear gloves or wash your hands between applications (if you have more than one affected nail.

Topical Mentholated ointment (Vicks Vaporub) is also used to treat onychomycosis. Apply it regularly to the affected nail at night.

But all said and done, Prevention is better than cure!

The best way to avoid fungal infections is to maintain a high level of hygiene.

Always keep your fingernails and toenails trimmed. Cut them straight and file down the thickened areas. Also make sure that they are dry and clean. After having bath, dry the toenails and even the area between the toes.
Avoid putting your hands or feet in water constantly.
Watch out for your manicures and pedicures. If the manicure or pedicure is done in a wrong way or with using contaminated instruments then you are at risk for developing onychomycosis.
Too much nail polish and or wearing artificial nails tends to trap moisture, which will allow the fungi to thrive.
Do not tear the skin around the nails or trim it. The slightest injury or cut allows the fungi to enter the nail.
Wear clean dry cotton socks, which will absorb the moisture and keep your feet dry. It is a good habit to remove your shoes occasionally especially after exercising.

7) Always wash your legs with soap and water after coming from out especially during the rainy season where we tend to step into dirty puddles.

Happy Feet = Happy Monsoon…..Enjoy!

February 17, 2017 By Dr Darshana Salve 2 Comments

Blood should circulate – Donate Blood!

We only understand the importance of blood donation when someone close to us is in need of it. A few days back my cousin contacted me to know the availability of blood for her friend’s father who met with an accident. Unfortunately, we lost him due to excess blood loss. We know of this incident because it’s a dear friend’s father but, on a daily basis there are so many such cases where there is loss of death due to non-availability of blood.

Statistics show that roughly every year in India there are 234 million major operations, 63 million trauma-induced surgeries, 31 million cancer-related procedures and 10 million pregnancy related complications which require blood transfusions.

Apart from these there are also disorders like sickle cell anemia, thalassemia and hemophilia that require repeated blood transfusions.

One of the main reasons for lack of blood is, many people are skeptical about blood donation. They have fears of contracting infections during blood donation, fear of the needle or feeling weak after blood donation. Human body approximately has 4.7-5.5 L of blood, out of it only 350/ 450 ml of blood is withdrawn during blood donation drives and it takes only a day or two to replenish the fluid volume in the body and three months for the regeneration of red cells to donate more blood.

There is no substitute for human blood. Blood cannot be manufactured – it can only come from
volunteer donors like you and me. One blood donation can save 3 lives. But, unfortunately only 1 % of volunteer donors come forward to donate blood and majority of the blood donation comes from replacement donors.

Replacement donors are friends and relatives of a patient who donate blood as replacement for the blood given to the patient.

At times, these replacement donors (friends and relatives) are more likely to harm the recipients by hiding or overlooking the many don’ts of donation.

Though voluntary self-referral to donate without citing reasons is widely accepted, replacement donors rarely adhere to it either to hide their high-risk behavior or due to pressure to meet the immediate demand for certain units of blood. As a result, the prevalence of HIV, hepatitis B, and hepatitis C is much higher among family donors when compared to voluntary donors, according to a 2012 study published in the Asian Journal of Transfusion Science.

Donation of safe blood can be achieved only when replacement donors are replaced by healthy volunteer donors to meet ‘over 95 per cent of blood requirement’. This can be done through increased awareness, providing appropriate facilities for people to donate blood, and improved donor retention.

While donating blood always be truthful about your health status!

Do not donate blood if you have any of these conditions

Cold / fever in the past 1 week.
Under treatment with antibiotics or any other medication.
Cardiac problems, hypertension, epilepsy, diabetes (on insulin therapy), history of cancer, chronic kidney or liver disease, bleeding tendencies, venereal disease etc.
Major surgery in the last 6 months.
Vaccination in the last 24 hours.
Miscarriage in the last 6 months or have been pregnant / lactating in the last one year.
Had fainting attacks during last donation.
Have regularly received treatment with blood products.
Shared a needle to inject drugs/ have history of drug addiction.
Had sexual relations with different partners or with a high risk individual.
Tested positive for antibodies to HIV.
If you are Underweight ( below 50 KGs)

Pregnancy and Menstrual Cycle

Females should not donate blood during pregnancy and lactation.
Females should not donate blood if they are having heavy menstrual flow or menstrual cramps.

Do donate blood if…

You are between age group of 18-60 years.
Weight is 50 kgs or more.
Hemoglobin is 12.5 gm% minimum.
Last blood donation was 3 months earlier.
You are healthy and have not suffered from malaria, typhoid or other transmissible disease in the recent past.

It’s time that we take up the responsibility to do voluntary blood donation. Donate Blood without waiting for a call.

December 15, 2016 By Dr Darshana Salve 1 Comment

Do You Really need an Antibiotic??

It’s December and with the slight nip in the air or with temperatures dropping come to all common illnesses like fever, cold, cough, sore throat, body ache etc. It’s a very common sight to find most people self-medicating with antibiotics. Every second person knows about it from the previous prescription or just by walking into the chemist’s store voicing their symptoms and getting their strip of antibiotics, like Azithromycin, Erythromycin, Amoxicillin, Cefuroxime, Cefixime etc. But, I really doubt if these people even know what antibiotics are and what they are used for!

Most of the people have this notion that it is a magic pill for common ailments like cold, cough, fever. Also, most are of the belief that with one or two doses of these tabs, they will be immediately cured of their ailment.

Well yes, I would say it is a magic pill but only for BACTERIAL INFECTIONS! Not all cold , cough, fever are due to bacterial infections, many a times its of viral infections which are self-limiting and needs to be controlled with paracetamol, taking rest and antibiotics have no role in treating viral infections.

So what are Antibiotics?
Antibiotics are powerful medicines that fight bacterial infections. When used properly, antibiotics save lives. They either kill bacteria or keep them from reproducing. Your body’s natural defenses can usually take it from there.
Common viral infections that do not benefit from antibiotic treatment include:

Cold
Flu (influenza)
Most coughs
Most sore throats
Some ear infections
Some sinus infections
Stomach flu (viral gastroenteritis)

Frequent and irrational use of antibiotics can cause Antibiotic resistance. Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth; in other words, the bacteria are “resistant” and continue to multiply in the presence of therapeutic levels of an antibiotic leading to treatment complications and increased healthcare costs.

In spite of growing awareness of antibiotic resistance in recent years, overuse still occurs for a number of reasons:

Doctors may prescribe antibiotics before receiving test results that identify the actual cause of infection.
People who want quick relief from symptoms, regardless of the cause of illness, may pressure doctors for antibiotic prescriptions.
People may take antibiotics over the counter or via the Internet for self-diagnosed illnesses.
People may take antibiotics that are leftover from a previous prescription.

Consequences of Antibiotic resistance

More-serious illness or disability
More deaths from previously treatable illnesses
Prolonged recovery
More-frequent or longer hospitalization
More doctor visits
More-expensive treatments

“Then what do we do to get better”, patients ask??

Antibiotic Stewardship is the answer for this problem which is basically the appropriate use of antibiotics.

Many hospitals and medical associations have implemented new diagnostic and treatment guidelines to ensure effective treatments for bacterial infections and reduce inappropriate use of antibiotics.

The public also plays a role in antibiotic stewardship. You can help reduce the development of antibiotic resistance by taking the following steps:

Use antibiotics only as prescribed by your doctor.
Take the correct daily dosage and complete the entire course of treatment.
If for some reason you have leftover antibiotics, kindly consult your Doctor before self-popping as they might not be the correct antibiotic.
Never take antibiotics prescribed for another person.
Don’t pressure your doctor to give you an antibiotic prescription. Ask your doctor for advice on how to treat symptoms and look into Lifestyle options for better prevention.
Practice good hygiene.

As for viral infections like common flu, we can fight it by building our immunity by modifying our lifestyle for the better. Eat right, exercise often, de-stress and make sure you sleep well to give your body the much needed rest.

So let’s bid adieu to 2016 on a healthy note and a pledge to Stop Antibiotic Resistance!