Medical Archives

January 26, 2019 By Dr Ashwin Nanda 2 Comments

Organ Donation – Gift of Life

A decade ago as a medical student, I had come across a blind man selling torches in the local trains. I asked him just out of curiosity the reason for his blindness to which he replied that he lost his sight in childhood after an accident which permanently damaged the blood supply to the retinas. He then went on to ask why I brought up the question and when I told him I was studying to be a doctor, he smiled and said, “I have a question for you”? I anticipated, he would want to know about recent advances in medicine that could probably restore his sight. But, I was wrong, instead, his question was different. His question was whether he could still donate his eyes. I was absolutely overwhelmed when he asked this. That is the day when I realized one can lose his eyesight but, still have a vision. With a sense of respect for him, I explained to him that his corneas could indeed be donated after his demise.

Organ transplantation is a marvelous procedure of modern medicine which helps the recipient gets a new lease of life. The only issue is, untimely demise of a loved one plunges the family and friends in so much grief that donating the deceased person’s organ doesn’t come to mind most times. It takes a mighty heart to brush aside the sorrow and take the step of organ donation, to give the gift of life to someone when you have lost a loved one.

Organ donation is permitted by law after a person is declared brain dead.A brain dead person has no chance of revival as all his brain activity has stopped permanently and completely. The medical fraternity follows very strict standards laid down by the Transplantation of Human Organs Act, 1994 to determine if someone is brain dead or not.

In India, it takes 4 well qualified doctors to declare brain death before a person’s organs can be harvested. The biggest hesitation in organ donation is that the body will be disfigured. The surgeon makes a single neat incision from top of the chest to the navel and after organ harvesting, it is stitched professionally and the body is handed back in the most dignified state. The organ/organs are stored in cooled containers with special preservative fluid.

Organ donation from brain dead individuals in India is very less compared to Europe and US. Live donor numbers are increasing steadily since it is possible for a relative to survive on a single kidney and even the left lobe of liver can be donated by a live donor as the liver regenerates.

2 lakh corneas are needed annually in India but only 50,000 donations happen. 5 lakh people die annually waiting for a lifesaving organ. Presumed consent for organ donation is used to increase the pool of potential donors in countries such as Austria, Belgium, Czech Republic, Finland, France, Greece, Hungary, Israel, Italy, Luxembourg, Norway, Poland, Slovenia, Spain, Sweden, Singapore and Turkey. After the death of the individuals the state becomes the custodian of the dead body, who take out the organs for transplant. Spain has the highest rate of organ donation at 36 / million. India is at 0.26/million only.

Who, What and How Can you donate?

1) Kidneys, Heart, Lungs, Liver, Small Bowel and Pancreas can be donated for transplant. Tissues that can be donated include eyes, heart valves, bone, skin, veins and tendons.

2) Every healthy person can donate. Old age is not a deterrent to donation. Person’s physical condition, not age, which is the deciding factor. Organs and tissue from people in their 70s and 80s have also been transplanted successfully.

3) Specialist health care professionals decide in each case which tissue and organs are suitable.

4) Your near and dear ones should be aware of your will to donate your organs. In case of your untimely demise they can inform concerned authorities to harvest your viable organs.

5) Kidneys, liver, heart need to be harvested within 6 hours of death whereas corneas within 12 hrs.

“Green corridor” is the term used when a lane from the airport to the hospital where the organ recipient is waiting is kept totally vacant for speedy transport of the organ by the doctor who has retrieved it from a donor in another city. The city traffic police officers go all out to ensure a smooth transit with zero stoppage. The nobleness of organ donation is highlighted by the efforts put in by them to help the cause.

Organ donation is easier said than done. This article is an attempt to increase awareness about this cause so that we all can create the mindset to be willing to donate organs. All religions promote this practice since extending life is considered an act of God.

So let’s pledge our organs and live even after we are gone.

Here are a few websites through which you can register and pledge your organs

www.mohanfoundation.org/

http://www.transplantindia.com/

donatelifeindia.org/

http://www.organindia.org/

January 24, 2019 By Luke Coutinho 2 Comments

Inflammation – What you should know?

When you think pain, think inflammation. Inflammation is a good thing. It’s your body’s way to rise up to fight germs/bacteria/infections, heal bruises when you fall, heal torn ligaments/tissues/tendons etc. Once it does its job of fighting out these invaders or foreign organisms, the inflammation should reduce to normal. The problem is when that doesn’t happen.

Have a torn ligament or muscle pulls that your struggling to heal? Seen the best doctors, therapists etc., and still not fixed? Struggling with arthritis and joint pain? Check your CRP (C-Reactive Protein) levels and focus on reducing inflammation. The cure is in reducing inflammation.

Many of us live with chronic inflammation and that’s dangerous. It’s also the reason people –struggle to lose weight, experience painful joint pain, age faster than normal,feel tired thru the day. Also with chronic inflammation there are higher chances of heart disease, Alzheimer’s/dementia, struggle with diabetes, feel depressed. Lowsilent inflammation can destroy your nerves and cellular health, suppressing and weakening your immune system, leading to deadly diseases like cancer, etc.

What’s scary is the fact that you can be extremely healthy and fit, but silent inflammation could

be eating into you from inside, which is one of the many explainable reasons why cancer or heart attacks can strike down a healthy and young human being.

Checking cholesterol levels, Vitamin D3, B12, SGOT, SGTP is imperative, but what most people miss out on is checking their CRP levels. (C-Reactive protein). This is such an important protein level to check and a simple blood test will cover that for you.

CRP level will tell you volumes about the amount of inflammation you have in your body. In my years of experience what stands out in a cancer report of a person is an increase in CRP levels and white blood cells and the immediate action is to reduce inflammation thru food and lifestyle change.Diseases breathe in inflamed environments, in environments that are acidic and in environments where there is less oxygen supply to the cells.

Over training causes inflammation.Vigorous exercise, inconsistent exercise and high intensity training which is not planned for your body type will make your CRP levels soar and kill your immunity, which is why many trainers ask their clients to take a Vitamin C and E post workouts. Running marathons without proper nutrition causes massive inflammation.

Chronic stress, Improper nutrition (high fat foods, sugar, artificial sweeteners, doughnuts, white sugar, aerated drinks, salty foods, packaged foods), Smoking causes inflammation. I’ve seen CRP levels fall in a smokers blood report within 10 days of kicking the butt.

How to keep your inflammation in check:

– Smart and moderate exercise

– Meditation and controlling your stress and BP levels,

– Nuts and seeds,Green leafy veggies and fruits.

– Good fats (like nuts, olive oil, coconut oil).

But, it has been proven that a small amount of alcohol can actually lower CRP levels.

-Vitamin D3, Curcumin (turmeric extract) is one of the best spice based inflammation fighters

January 17, 2019 By Trishala Chopra 1 Comment

Effect of different medications on exercise!

statins (1) (2)

Either you or somebody you know might be on some kind of long term medications! I am not talking about somebody who takes an aspirin or a paracetamol or some antipyretic. When I say long term medications-I am talking about cholesterol, blood pressure and blood sugar lowering drugs. When a patient usually gets on any of these drugs there are high chances that they are on them forever!

Each one of these medications has a tremendous impact on the body which comes as a blow if you an exercise person!

Every medication has a different set of action, here are some points for you to keep in mind!

(1) Cholesterol medications

statins

Most commonly used cholesterol medication is statin.
The generic names of these drugs mostly available are Rosuvastatin, Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Simvastatin, Pitavastatin.

(To check which statin is your medication- check behind the tablet. Salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

Statins deplete CoEnzyme Q10 in the body which is very important for muscles to make energy. This will affect your strength training routine. Post strength training recovery will be slow.
It might also lead to rhabdomyolysis which means muscle death is definitely not good!

So, what can be done?

The first thing which you should always try is getting off statins as soon as possible with some changes in your diet and exercise routine. You can ask your coach to help you with this! (Let your doctor change your medicines and coach can guide the path to that!)
While you are on a statin, you should always try a gradual progress. Do not rush into any kind of exercise routine. Give your body enough time to get adapted.
Take longer recovery time. Instead of having a 1-day gap between your strength training schedules you can take 2 days gap which will give your muscles more time to recover! You can do light workouts on the day when you don’t plan to do strength training.

(2) Beta blockers

beta blocker

This is a group of medications used for lowering down the high blood pressure.
Most commonly used beta blockers are atenolol, bisoprolol, propranolol, metroporolol.

(To check which beta blocker is your medication- check behind the tablet. Salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

People who are on beta blockers see that their heart rate is always less no matter what form of exercise they do. Maintaining a proper heart rate during different activities is very important for having a good cardiac health.
People taking beta blockers witness that their heart rate after a sprint and after a moderate jogging is exactly the same. In fact, this shouldn’t be the case. It has to be more while sprinting than jogging.

So, what can be done?

Instead of checking your heart rate for your exercise progress, start checking your exertion timing.
If you start panting very soon, note that time. Work on your stamina and then go ahead. Beta blockers will always keep your heart rate low.

(3) ACE inhibitors

pharmacology-of-ace-inhibitors

These are another set of medications which are used in the treatment of lowering your high blood pressure!
Most commonly used ACE inhibitors are fosinopril, lisinopril, quinapril.

(To check which ACE inhibitor is your medication- check behind the tablet. The salt name is always mentioned. If in case it is not mentioned, check it on company’s site)

There are 2 types of people- One who has high blood pressure and is not taking any medication and another one who has high blood pressure and is on either beta blocker or ace inhibitor. If the person without the medication exercises, his blood pressure will come down automatically post exercise. This is called as post exercise hypotension.
This even happens with someone who is a blood pressure medication, but then it can go really very low! That’s the reason people feel dizzy, shaky, nauseous, blurred vision post exercise. Sometimes the person can faint as well.

So, what can be done?

For obvious reasons, you cannot skip the medications and neither can you skip your workout but you can definitely manage it.
For people on BP medications, you should cool down a bit longer than an average person. Instead of a 5-minute cooldown, do a 10-minute cooldown.
Your heart beat tracker can help you in this!
For example, if your heart rate is 140 beats per minute- Post workout it can drop to 110 which is ok. After another minute it might go further low to 90. Hold on. Breathe it. Stretch yourself. Your targeted heart beat should be only 10% more than your RHR (Resting heart rate) which is around 60-70 beats per minute.

(4) Blood sugar lowering medications

lower blood sugar

There are different blood sugar lowering medications which affect the body in different ways.
Either they increase the insulin function, or removes excess sugar out through urine or decreases the amount of carbohydrate absorption in the body
For a non-diabetic person, while exercising there are different hormonal fluctuation which happens. Adrenaline is released followed by a surge in the cortisol levels and these hormones rise the blood sugar levels. To bring this down, pancreas secretes another hormone called as insulin which brings the elevated sugars down. So, the fluctuation is not seen whereas this is not the case in people with diabetes.
Some medications can cause hypoglycemia (Blood sugars below 70) in diabetics.

So, what can be done?

Well, in this case, nothing much can be done apart from monitoring.
Check your blood sugar levels before exercising, middle of the exercise and after the workout gets over.
Keep half glass of fruit juice or 1 glass of milk always with you and if the sugar drops please consume either of this.
Do strength training, reduce your carbohydrates, add enough proteins to your routine and ask your doctor to reduce your medications!

Questions for me? Please drop in the comments below!

January 10, 2019 By Urvashi Sareen 11 Comments

Acidity – its symptoms and Prevention

Acidity is one of the most common problems that most individuals face. This is largely due to wrong eating habits and sometimes even stress. Bad eating, stress in a way is all connected. One leads to another and that, in turn, leads to unhealthy living and problems such as acidity.

But, to find a solution to the problem it is first important to understand what is Acidity?

Acidity is a term used for a set of symptoms caused by excess production of acid by the gastric glands of the stomach. The stomach normally secretes hydrochloric acid which is required for the breakdown and digestion of food that we eat. Acidity causes symptoms like dyspepsia, heartburn gastric inflammation, and ulcers in the stomach.

Now, there are some factors which cause acidity such as eating habits, fad diets, stress, smoking and alcohol consumption, lack of physical activity, irregularity in eating pattern, consumption of oily and spicy foods. Apart from these certain medicines are too responsible for the cause of acidity.

Some of the symptoms which can be felt as a result of acidity can be:

Burning session in the stomach
Burning session in the throat
Restlessness
Belching
Nausea
Sour taste
Indigestion
Constipation

As correctly said, “Prevention is better than cure”

So let us look at some of the parameters to prevent acidity.

Don’t consume spicy food or fried foods too often.
Eat more fruits and vegetables. One should be taking at least 2 servings of fruits and 3-4 servings of vegetables. Green leafy vegetables would be a really good choice to go for.
Eat small, regular meals. Try to reduce the gap between meals to not more than 3 hours.
Consume your last meal at least a few hours before sleeping.
Chew tulsi leaves, cloves, saunf (Aniseed), etc.
Avoid medications like NSAIDs (non-steroidal anti-inflammatory drugs) and steroids
Reduce stress. Deep breathing, going for a walk and being in nature are some of the activities which can help in reducing stress.

However, if you are already suffering from acidity, I am discussing below some of the home remedies of acidity which really work. So before you start with antacids for the treatment, do try these home remedies and you may get rid of the problem.

Basil leaves: Eat basil leaves thoroughly at first sign of acidity. Can also boil 4-5 leaves in a cup of water for 15 minutes.
Cinnamon: Add half spoon of cinnamon powder in a cup of water, boil for few minutes and drink this 2-3 times a day.
Buttermilk:

Grind half to one teaspoon of methi seeds with little water to make a paste. Mix it in a glass of buttermilk and have it.
Add a tablespoon of white vinegar or lemon juice to a cup of buttermilk and keep it for 5 minutes before drinking.
Mix a pinch of black pepper in a glass of buttermilk.
Mix a tablespoon of coriander leaf juice in a glass of buttermilk.

Apple Cider vinegar:

Mix 1-2 teaspoon of apple cider vinegar in half a cup of water and drink.
Mix 2 tablespoon of apple cider vinegar with 1 teaspoon of organic honey and drink before eating a spicy meal.

Cloves: Chew 2-3 cloves thoroughly.
Jaggery: Jaggery is high in potassium. After each meal, take a small piece.
Ginger:

Can take 2-3 teaspoon of ginger juice in a day for combating acidity.
Can boil ginger in water and drink the water twice a day.

Cumin seeds:

Crush roasted cumin seeds and stir in a glass of water. Drink after each meal.
Boil seeds in water, strain and drink.
Mix 1 teaspoon of coriander seed powder, a teaspoon of cumin seed powder and a teaspoon of fennel seed powder and some sugar in half cup of water and drink empty stomach.

Aniseed: Soak a teaspoon of aniseed in a cup of boiled water overnight. In the morning, strain the water add a teaspoon of organic honey and sip it at least 3 times during the day.
Cold milk: After a meal, drink a glass of cold milk, not iced milk.
Lemon and ginger juice 15 minutes post meal, zaps acidity quickly.

If eating right and proper preventive measures are adhered to, Acidity can be averted.