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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 Human body approximately has 4.7-5.5 L of blood, out of it only 350/ 450 ml of blood is withdrawn during blood donation drives and it takes only a day or two to replenish the fluid volume in the body and three months for the regeneration of red cells to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.

October 20, 2016 By Dr Anand Kulkarni 3 Comments

OSTEOPOROSIS

How often have you come across your parents, grandparents or an elderly relative who has had a minor fall in the bathroom, slipped on the floor or had a terrible jerk while travelling on a bumpy road and sustained fractures of bones with a lot of pain, suffering and disability.

It has been noticed that the culprit for such incidents is OSTEOPOROSIS.

Osteoporosis is one of the most common disabilities encountered in the elderly. It literally means POROUS BONE. The condition results in reduced density and increased fragility of bones resulting in higher risk of fracture with minor falls, cough, sneeze, or minor bumps.

The condition is observed worldwide. There are more than 10 million cases per year in India. In the USA about 55% of its population aged 50 years and older have Osteoporosis. One third have disabilities and one third regain their pre-fracture status. The health costs from fractures are tremendous amounting to billions of dollars annually.

It is very important to learn about osteoporosis because it is a ‘SILENT DISEASE’ except occasional bone pains. You may not know that you have osteoporosis until your thin weakened bones fracture in a bump or fall. The more common sites are Hip, Spinal Vertebrae and Wrist.

Clinical studies suggest that approximately 1 in 2 women and 1 in 4 men aged 50 years and older will break a bone due to osteoporosis. Such people in this age group usually present with chronic vague backache, loss of height, or stooping (Kyphosis) and should consult doctor immediately.

THE RISK FACTORS ARE,

Advanced age
Family history of osteoporosis
Early menopause
Short Stature
Lack of Exercise
Poor nutrition with lack of Calcium
Lack of Vitamin D
Chronic Cigarette Smoking and Excessive Alcohol Consumption
Medical Illnesses- like hyperthyroidism, surgical removal of ovaries, long term steroid therapy and rare inherited bone disorders like Osteogenesis Imperfecta.

SCREENING is advised for all elderly above 65 years of age and Men and Women less than 65 years of age who have increased risk of fracture or already suffered from fracture.

DIAGNOSIS – is by bone scan which measures-Bone Mineral Density (BMD). The test called DEXA (Dual Energy X ray Absorptimetry) gives indication of likelihood of fracture due to osteoporosis.

It is also used to monitor response to treatment.

Result.— T score a) ( -1) and above ——- normal

b) (-1) to ( -2.5) ——- mild bone loss or osteopenia
c) ( -2.5) and below —- osteoporosis

Our aim should be to prevent bone less or slow down the occurrence of Osteoporosis and encourage healthy bone mineralization.

Following measures are recommended:

Healthy Nutritional Diet – To be incorporated during childhood and adolescent period itself with adequate calcium and magnesium intake. Calcium intake should be 1000 to 1200 mg per day. Common calcium rich foods are dairy products, cheese, ragi, broccoli, spinach, cabbage, green beans, soy beans, okra, dates, egg, salt water fish and fruits like orange, figs.
Vitamin D intake of 800 IU per day is a must. We encourage exposure to SunLight and supplementation as Vitamin D requirement cannot be fulfilled through nutrition alone.
EXERCISE plays a major role. Weight bearing exercises like walking, playing golf, Dancing, Hiking, Racket sports like Tennis, Squash promote mineralization of bones and make them healthy. Muscle strengthening exercises like weight lifting benefit by increasing muscle strength and Non- Impact activities like YOGA help in balancing, posture, agility of joints and benefit people with osteoporosis by decreasing the risk of falls and fractures.

Studies have also reported an increase in BMD in the spine of those who do YOGA regularly. Exercise should be tailored to the individual person based on BMD report and medical condition in consultation with health care professional.

Other Lifestyle Changes – Have a Positive Attitude towards Life, avoid the use of tobacco and Cigarette Smoking, moderate alcohol intake if any, and measures to avoid falls like having railings, avoid slippery floors, having a mat or carpet on the floor helps etc.

Medications—You may also require osteoporosis medications to either build or maintain bone density. People have been treated with medications like Bisphosphonates, Hormone Therapy in Women, Calcitonin, Parathyroid Hormone. Stem Cell Therapy is also being tried out in severe cases.

But, any of these modalities of treatment should be undertaken in consultation with your Doctor. The doctor is the only one who will be able to decide the right treatment for you weighing the benefits and risks of the therapy.

Cultivate healthy living and enjoy life!

October 4, 2016 By Dr Manali Rao 1 Comment

What is contraception?? Birth control or fertility control

Why or how does it play such a major role in the betterment of a society? I have a little story to share. Like all women, my friend was also super excited about her wedding. It was the perfect match, the man was perfect with a well-paying job, loving family and most importantly he was a man with a heart of gold. Are you wondering how our discussion on contraception fits into the scheme of this here?

Let me explain. Here’s what happened! Couple of days before their big day, my friend’s to be husband made it very clear to her that he does not want to use any contraceptive. But, he did not want a child for a year at least. And, that he also did not want her to use a barrier method of contraception (female condoms) either! The other conditions laid down by her to be partner was also that she had to lose weight and remain slim for the rest of her life. This is kind of a heard story right? It does not come as a surprise.

Now, my friend was in atotal fix. There were so many terms and conditions and unfortunately she had no say in the matter. It was told to her and she had to follow it. She was not very keen on OCPs (Oral Contraceptive Pills) given their side effects like weight gain, nausea, sore or swollen breasts, lighter or heavy periods, mood changes, abdominal pain and headaches. So what other option was she left with?

IUCD (Intrauterine Contraceptive Device)-It is a small contraceptive device, often ‘T’-shaped, containing either copper or levonorgestrel, which is inserted into the uterus. They are one form of long-acting reversible contraception which are the most effective types of reversible birth control.

Was my friend aware that it is not advisable to use IUCDs unless you have conceived at least once? Nope! She wasn’t aware nor did she take any medical advice. So just to keep her husband happy, she opted for IUCD.

What happened next?!!

She started having adverse effects like excessive bleeding during menses, abdominal pain, and loss of weight and before we knew it, she looked under nourished.

What led to all this? Who was to be blamed? Was it the girl’s fault? Or was it her husband, who had the notion that using a barrier method reduces the pleasure or the basic psyche that the girl must to do all that pleases her husband irrespective of what the consequences could be. I would say all three and most importantly it’s the lack of knowledge about contraception.

I am saddened by the thought that some people still think contraception is unnecessary as it decreases libido and that it’s a taboo. Well, trust me folks it is not so. When one uses contraception, they can avoid unwanted pregnancies and space planned pregnancies to promote optimal birth outcomes.

When a pregnancy is planned, one can start prenatal care, including increasing their intake of folic acid; work with the gynecologists to address relevant medical conditions, as well as substance abuse; and take other steps that lead to healthier outcomes for both the mother and the infant.

Pregnancies that are unplanned are more likely to be affected by delayed prenatal care, maternal depression, low birth weight, poorer childhood physical and mental health, and other complications. Breastfeeding rates are also lower after unintended pregnancies. We should also remember that most of the unintended pregnancies end in abortion, which affects both the parents psychologically and affects the mother physically.

When you look at the facts, contraception is a smart public health policy.

Of course, for some women, birth control is essential for other health reasons, including acne, fibroids, and endometriosis and to reduce problems associated with irregular or very heavy periods.

There are several methods of contraception:

Natural Family Planning (NFP): Couples can use NFP techniques like the rhythm method, basal body temperature, or the cervical mucus method to try to pinpoint when a woman is ovulating (fertile). To prevent pregnancy, sexual intercourse is to be avoided around the time of ovulation.

Other methods include barrier method (condoms), OCPs, IUCDs.

Remember, contraception plays an important role in the well-being of the family and the society as a whole.

Finally, don’t forget to consult your gynecologist for advice on the right Contraceptive method for you.

August 26, 2016 By Trishala Chopra Leave a Comment

Know what Bone Mineral Density is ?

Woman are always considered to be the torch bearer of health and to pass on that heritage to the future generations, just like our grandmother did for our mother and everyone in the family. But, it is not easy to leave behind a legacy of health and harmony. To be able to do that women need to make sure that they make time for themselves amidst all the responsibilities they shoulder both at home and outside of home and lead a healthy life with good nutrition, exercise and rest.

IMPORTANT POINTS THAT ALL WOMEN SHOULD KNOW:-

Bone mineral density or also called as BMD is the density of minerals such as calcium which is present in the bone.
Bone mineral density reduces drastically in post-menopausal women
Bone mass is lost after a certain age.
In post-menopausal women, calcium is leached out of the body which is why they are at a higher risk of developing bone issues.
Bones naturally become thinner and this condition is called as ‘osteopenia’.
Bones loose minerals such as calcium, becomes less dense and gradually becomes porous which makes the bones more susceptible to fractures
If the bone gets more thinner, ‘osteopenia’ can lead to ‘osteoporosis’
So thicker the bones, longer it takes to cause osteopenia or osteoporosis.
Bone mineral density tests should be done to check the exact peak density of the bone.
It the tests results shows that bone density is a bit lower than normal which means that it is the start of osteopenia. In such cases, bone density can be increased.
Adequate calcium plays a key role in maintaining bone density.
It is advisable that all the women who have crossed 35 years of age and post- menopausal women should get their bone mineral density checked. After all ‘PREVENTION IS BETTER THAN CURE’!

THINGS YOU SHOULD DO TO DELAY BONE THINNING:-

It the tests results shows that bone density is a bit lower than normal which means that it is the start of osteopenia then the bone density can be increased by exercising, lifting weights, consuming adequate amount of calcium and vitamin D
Consuming adequate amount of calcium and vitamin D are the key to strengthen your bones.
Vitamin D helps in absorption of calcium in the body hence both of these nutrients go hand in hand.
Include lots of dark green leafy veggies which are a very good source of calcium.
Along with calcium, potassium and magnesium are also responsible in maintaining the bone health though in small amounts. Low levels of magnesium can hinder vitamin D balance.
Dairy products are again a well-known and rich source of calcium.
Most of the foods are fortified with calcium these days so that the peak bone mass problem does not occur in early ages.
Calcium supplements are also available which can be consumed.
Handful of almonds in your diet can be a very good calcium source.

Bone loss and Osteoporosis can be prevented in the future. So keep healthy- healthy habits such as eating foods in rich in calcium and Vitamin D and doing strength and weight bearing exercises such as walking, running, cycling or dancing all help.