Worried about abnormal lipid profile!

Lipid function test is done on a fasting blood sample for identifying various lipid abnormalities and it includes the estimation of total cholesterol, Triglycerides, HDL-cholesterol, LDL-cholesterol. 

The major lipids present in the blood are cholesterol and triglycerides, which are transported in blood after incorporation into lipoproteins like chylomicrons, very low-density-lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). 

Disorders of lipoprotein metabolism (Dyslipidemia) include primary and secondary conditions that increase circulating lipids.

HDL is considered as good cholesterol as it carries cholesterol to the liver from where it can be removed from the bloodstream before it builds up in the arteries. LDL on the other hand takes the cholesterol directly to the arteries which can cause plaque buildup and atherosclerosis which can eventually lead to heart attacks. Hence, LDL is termed as bad cholesterol.

Hypercholesterolemia (increased total cholesterol in blood), is a cause of cardiac diseases that is highly treatable and, therefore, persons should be actively screened. It is recommended by the National Cholesterol Education Program that a fasting lipid profile should be carried out every 5 years beginning at the age of 20 years.

Preparation needed for Lipid Profile Test:

  1. Sample for lipid analysis requires 12-hour fasting. 
  2. Triglycerides and LDL are affected by recent ingestion of food. Patients should be on a routine diet for 2-3 weeks before analysis.
  3. Lipid analysis should not be performed during acute illness and should be postponed for 3 months after a major illness.
  4. Drugs affecting lipid levels like steroids, oral contraceptives should be avoided. 

Possible underlying causes for Lipid profile abnormalities:

  1. Patients with high serum triglycerides>200 mg/dl have the risk of atherosclerosis, and those with >1000 mg/dl are at increased risk of acute pancreatitis. 
  2. An increase in triglyceride is associated with low HDL. Low HDL-cholesterol is a risk factor for coronary diseases even if the total cholesterol level is normal. 
  3. High LDL-cholesterol is a strong risk factor for atherosclerotic heart disease and is associated with obesity, high carbohydrate food intake, diabetes mellitus, lack of exercise, smoking.
  4. Secondary lipoprotein diseases arise from underlying causes like diabetes mellitus, alcohol abuse, hypothyroidism.

Management of Dyslipidemia:

  1. For patients who are overweight, weight loss can help to reduce triglyceride levels.
  2. Obesity or overweight care involves three essential elements of lifestyle: dietary habits, physical activity, and behavior modification. 
  3. Lifestyle changes are the first thing to tackle to reduce your chance of heart disease.
  4. Patients should receive dietary counseling to reduce the content of saturated fats, artificial trans fats, and cholesterol in the diet.
  5. The primary focus of diet therapy is to reduce overall calorie consumption. This reduction is consistent with a goal of losing 0.5-1kg/week. Examples include:
    • Choose smaller and frequent meals at regular intervals.
    • Eat more fruits and vegetables.
    • Increase intake of dietary fiber.
    • Consume more whole-grain cereals, beans, peas.
    • Select leaner cuts of meat and skimmed dairy & dairy products.
    • Reduce consumption of fried foods and foods with added fats and oils.
    • Drink water instead of sugar-sweetened beverages, reduce sugar and sweets. 
    • Decrease sodium intake.
    • Reduce saturated fat intake which you find in animal products. 
  6. Foods with low-energy-density include soups, fruits, vegetables, oatmeal, and lean meats should be preferred. 
  7. Foods with high-energy-density such as dry foods and high-fat foods such as cheese, egg yolks, potato chips, and red meat have a high-energy-density and should be avoided.
  8. The purpose of a Very Low-Calorie Diet (VLCD) is to have rapid and significant short-term weight loss over a 3 to 6 month period. 
  9. A combination of dietary modification and exercise is the most effective behavioral approach for the treatment of obesity.
  10. Adults should engage in 150 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity throughout the week.
  11. Regular aerobic exercise can lower bad cholesterol (LDL) and raise good cholesterol (HDL). Maintain adequate weight for your height.
  12. Have foods with unsaturated fats like nuts, fish, vegetable oil, olive oil, canola, and sunflower oils.
  13. Patients who drink alcohol should be encouraged to decrease or preferably eliminate their intake.

If diet and exercise don’t lower cholesterol levels, then medications or a combination of treatments are prescribed by your physician after ruling out secondary causes.

-Dr. Pendurthy Anoosha

References:

  1. Jameson, Fauci, Kasper, Hauser, Longo, Loscalzo: Harrison’s principle of internal medicine, 20th ed, Ch 400, pg 2889-2902.
  2. Shirish M. Kawthalkar: Essentials of clinical pathology, 7th ed, ch 5, pg 69-74.

Management of Psoriasis

Psoriasis is a skin disease that causes scaling and inflammation. Skin cells regrow in around 28 days normally but this reduces to 4 days in psoriasis. This can lead to piling up of skin cells leading to thick, dark red patches with silvery scales and itching around the infection. Patches generally occur around the elbows, knees, legs, scalp, lower back, face, palms, and the soles of the feet.

There is no specific cure of psoriasis but the focus is on managing it to keep the symptoms to a minimum. The management is based on severity and type of psoriasis.

Treatment of Psoriasis

Psoriasis treatments aim to stop skin cells from growing quickly and to remove scales.

Treatment options include-

Topical agents–  These are ointments /creams which are applied directly to the skin to reduce inflammation and itching.

Systemic treatment– This generally includes immune suppressors which reduces the immune response.

Light therapy– Combined with medication, natural/artificial ultraviolet light is used to slow down the growth of cells.

Living with Psoriasis

Most Psoriasis patients feel it a day to day problem and may become depressed, self conscious and fear rejection in the society. This can lead to psychological issues and mental stress.

Following are the points to manage Psoriasis effectively-

  • Do not delay treatment when symptoms are mild as the symptoms may flare up without it.
  • Psoriasis outbreaks are often triggered by external factors. Keeping a diary can help identify triggers.
  • Inform your dermatologist if you are pregnant or intend to get pregnant. Pregnancy can flare up symptoms and treatment options have to be optimised.
  • Take medication as directed to ensure maximum benefit. Never stop taking your medication without your dermatologist’s approval.
  • After receiving light therapy,  your symptoms may worsen before improving. 
  • Avoid self treatment.
  • As psoriasis begins to heal, skin tends to flake and peel and may feel itchy. When itching is a problem, skin moisturizers may help.
  • Being overweight increases the severity of psoriasis and reduces the effectiveness of treatment hence weight loss has a positive impact on management of Psoriasis.
  • Smoking and alcohol plays a role in the onset of psoriasis and future flare-ups. Hence quit smoking and limit alcohol intake.
  • Follow a healthy lifestyle. Hypertension, high cholesterol level, and lack of exercise increase the risk for psoriasis. 

Learn as much as possible about psoriasis. This will improve understanding of the disease, triggers, and will help in management and living with Psoriasis easier.

By, Dr Prerna Gaur

Acknowledgement:

https://www.healthline.com/health/psoriasis

https://www.webmd.com/skin-problems-and-treatments/psoriasis/default.htm

https://www.uptodate.com/contents/treatment-of-psoriasis-in-adults

MISCONCEPTIONS ABOUT COVID-19 ANTIBODY TESTING

There is a lot of confusion among people about COVID-19 antibody testing. Most people think that they are tested positive for COVID-19 if they test reactive for antibodies. The misconceptions are cleared below.

What is COVID-19 antibody test?

COVID-19 antibody test is also known as serology test which is usually a blood test. The test tells if there are antibodies present against SARS-CoV-2, the virus that causes COVID-19. Presence of antibodies in the blood usually indicates our body is fighting or has fought against an infection. Antibodies help you to fight against the infections and can protect you from getting the same infection again. How long the protection lasts is different for each disease and each person. 

Antibody test results are not taken into consideration to diagnose someone with active infection.

What are the types of antibody testing?

  • IgM antibodies, which happen early in an infection. You will be tested positive for IgM antibody if you have been infected recently and that your immune system has started responding to the virus.  When IgM is detected you may still be infected, or you may have recently recovered from a COVID-19 infection.
  • IgG antibodies, which are more likely to show up later. These antibodies indicate that you have had COVID-19 in the recent past and have developed antibodies that may protect you from future infection. It is unknown at this point how much protection antibodies might provide against reinfection.

Do we need to isolate ourselves if we are tested positive for COVID antibodies?

  • If you are tested positive for both antibodies (IgM and IgG) and have symptoms related to COVID-19, it is advisable to go for RT-PCR test to confirm if there is any active infection. Isolation is suggested till you are symptom free.
  • If you have tested positive for IgG antibody and don’t have any symptoms, no isolation is needed.

What if the Antibody test is Positive?

Below are the few possibilities if you are tested positive for antibodies:

  • You must have been infected with COVID-19 in the past.
  • You can test positive for antibodies even if you have never had symptoms of COVID-19. Asymptomatic infection in which there will be no symptoms even if you have been infected, can be the cause for such a result.
  • You have to talk to your doctor if it is positive, as there are 2 types of antibodies as explained above and to know if there is any active infection based on the type of antibody tested and current clinical condition.
  • There is a chance that a positive result means you have antibodies from an infection with a different virus from the same family of viruses called coronaviruses.

What if Antibody test is Negative?

There are few possibilities which can be the reason for negative result:

  • You have current active infection in which antibodies are not developed yet and you need to go for RT-PCR to confirm the diagnosis if you have symptoms related to COVID-19.
  • You may not have been infected with COVID-19 in the past.
  • Some people may take longer to develop antibodies. 
  • The result may be wrong, which is a false negative.
  • As the vaccine is out now and soon most of the people will be vaccinated. In case you are vaccinated, you can’t see antibodies if you go for antibody testing.

Whatever the result may be, taking good precautions to prevent the disease is a must.

References:

https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-antibody-tests/faq-20484429

https://www.webmd.com/lung/antibody-testing-covid-19#1

https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests.html

https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/antibody-serology-testing-covid-19-information-patients-and-consumers

 By,

 Dr. Y. Alekhya.

Corona Virus – All that you need to know!

Don’t panic….. instead, take precautions for avoiding infection with 2019 Novel Coronavirus (2019-nCoV)

Human Coronavirus has been the most heard word in the world in recent times, because of its outbreak which was recognized in Wuhan, China in December 2019. Human coronavirus is usually considered for causing the common cold in otherwise healthy people. However, in the 21st century the two highly pathogenic human Coronaviruses which are Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS- CoV) emerged from the animals sold for foods, they are suspected to be reservoirs to cause Global epidemics with a high rate of morbidity and mortality. Because of the recent outbreak in China, human Coronaviruses received more attention.

In December 2019, pneumonia cases of unknown cause emerged in Wuhan, China with clinical presentations resembling viral pneumonia. After the proper analysis of the lower respiratory tract samples, indicating a novel coronavirus, it was named as ‘2019 novel coronavirus’ (2019-nCoV).

 Mode of Spread:

The initial spread is thought to be from animal to man, as the first identified infected individuals were workers at a seafood market. But later spread to a few individuals with 2019 novel Coronavirus indicated a person to person spread similar to influenza and other respiratory pathogens’ spread. It is thought to have happened mainly by respiratory droplets produced when an infected person coughs or sneezes.

 Symptoms:

Common symptoms reported are:

  1.       Fever
  2.       Fatigue
  3.       Dry Cough
  4.       Shortness of breath
  5.       Headache
  6.       Blood while coughing, chest pain
  7.       Sometimes diarrhea

Severe infection can result in pneumonia, kidney failure, and death.

How is the diagnosis made?

Any person fulfilling the epidemiological and clinical criteria should be tested for 2019-nCoV. 

Epidemiological criteria:  Any person with travel-history to Wuhan City, China in the 14 days before the onset of illness OR Any person being in close contact with a laboratory-confirmed case of 2019 novel Coronavirus, 14 days before the onset of illness.

Clinical criteria: Any person with clinical symptoms compatible with severe acute respiratory infection seeking healthcare or admitted to hospital with clinical or radiological evidence of pneumonia OR Any person with fever or recent history of fever (>=38°C) and acute respiratory infection (sudden onset of respiratory infection with one or more of the following symptoms: shortness of breath, cough or sore throat)

Diagnosis is made through laboratory testing of respiratory specimens and serum (blood). The specific test currently recommended by WHO for the diagnosis and confirmation of 2019-nCoV is by real-time RT-PCR.

Treatment:

Currently, there is no specific treatment recommended for the respiratory illness caused by the ‘2019 novel coronavirus’. Symptomatic treatment is given to help relieve symptoms. Support for the vital organ function should be given in severe cases.

How can you protect yourself?

  1.  Washing hands for at least 20 seconds with soap and water when you come home from the outside is advisable.
  2.  You can also use an alcohol-based hand sanitizer when soap and water are not available
  3. Avoid touching your eyes and nose repeatedly.
  4. Covering your nose and mouth while you cough or sneeze with tissue is advisable
  5.  Avoid close contact with people who are sick with respiratory symptoms. 
  6.  It is advisable to stay at home when you are sick so that you don’t spread germs to others.
  7.  It is necessary to clean and disinfect objects and surfaces frequently.
  8. Avoid huge gatherings and crowded places.
  9. People with other chronic medical conditions, elderly, infants and children need to be given special protection and care
  10. Pregnant women too need to take extra precautions to avoid the infection with Corona Virus 

 Avoiding exposure to the virus is the best way of prevention.

Currently, there is no vaccine for the 2019 Novel Coronavirus. Trails are going on for the same.

References:

https://www.webmd.com/lung/coronavirus#1

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

– Dr. Y. Alekhya.

 

Winter health woes and how to deal with them

The winter almost set in and with the various joys and good moments, it also brings with it certain health issues that we need to be vigilant about. Read on to know the health problems that are commonly seen in winter and what we can do about them.

Bone, Joint and Body pains – dropping temperatures are known to cause an increase in joint and bone pains. This season is especially very troublesome for people who suffer from arthritis.

Useful tips to prevent/deal with joint pains-

  • Keep your joints warm.
  • Make sure to do light warm up exercises.
  • Massaging the joints that hurt, with warm oil can help.
  • Adding supplements such as vitamin D, omega-3- fatty acids after consulting your doctor can help.
  • Keep your pain relievers handy.

Respiratory system challenges – Cold weather is known to cause increase in cases of respiratory system issues like Asthma, flu, common colds, sinusitis, bronchitis, sore throat and pneumonia.

Useful tips to prevent/ deal with them-

  • Keep safe from very cold air/wind when going out by covering your mouth and nose lightly.
  • If you are an asthmatic, meet with your doctor and update yourself on medication that you may be needing and stock them so that they are handy when you need them.
  • Influenza, flu, sore throat and pneumonia are contagious diseases and can be prevented by following simple measures like wash your hands regularly and covering your mouth when sneezing/coughing.
  • Taking enough rest, exercising on regular basis, eating healthy diet and keeping yourself hydrated can help.
  • For sore throat, gargling with warm water and salt can help.
  • If you regularly face problems with respiratory system, arranging for a steam machine or a nebulizer is to be considered.

Winter skin problems – dry itchy skin, chapped lips, flaky skin, cracked feet and pre-existing skin disorders like eczema and psoriasis can flare up in winters due to the dryness in air.

Useful tips to prevent/deal with winter skin problems-

  • Stays hydrated and moisturize your skin with natural moisturizers.
  • For flaky skin, exfoliate and then moisturize.
  • For chapped lips, lips balms or creams that contain vitamin A and Vitamin E can help and work best if applied on moist lips.
  • For itchy skin, it is best to avoid long times in warm showers
  • It is best if woollen clothes are not in direct touch with skin.
  • If you have a pre-existing skin condition, keep away from harsh soaps or chemicals and keep your medicated creams ready!

Heart problem in the elderly – if you have an elderly at home, now is the season to get them evaluated especially if they already have pre-existing issues of heart or blood vessels since due to drop in body temperature (hypothermia) in the colder months the heart is affected by increased heart rate and blood pressure, where the heart needs to function harder to keep the body warm.

Useful tips to prevent/deal with heart problems/ hypothermia in elderly-

  • Install thermostats in homes to keep the temperature at a constant, safe temperature.
  • Hot water bags or electric blankets can be used.
  • Encourage them to do some mild exercise.
  • Special steps must be taken in cold seasons for their health evaluation and they must be encouraged to take their medicine on time.

By,

Dr.Afroze Fatima

References-

https://www.india.com/lifestyle/winter-health-problems-5-common-health-problems-in-winter-and-how-to-prevent-them-2752331/

https://www.mapsofindia.com/my-india/india/5-most-common-winter-illness-you-must-be-aware-of

https://www.skymetweather.com/content/health-and-food/5-ways-to-enjoy-disease-free-winter/

https://www.onlymyhealth.com/winter-health-problems-1292484682

https://www.quora.com/What-diseases-are-generally-common-in-India-during-the-winter-the-rainy-and-the-summer-seasons-and-how-can-you-prevent-them

https://www.indushealthplus.com/common-winter-health-problems.html

https://www.hdfcergo.com/blogs/health-insurance/precautions-to-be-taken-in-winter.html

 

NOCTURIA

NOCTURIA- If you are having to get up at night to pee more than you usually do, here is an article for you!

A frequent need to get up to urinate at night is called nocturia. To get up once to urinate is said to be normal. However, if a person has to 2 or more than 2 times in one night (6-8 hours of sleep), nocturia is suspected.

Nocturia is seldom a disease in itself, it is often a symptom of other underlying causes which include certain lifestyle habits or medical conditions.

Causes of Nocturia-

  1. Drinking too much or too close to bedtime is one of the most common causes of nocturia.
  2. Having alcohol or caffeine late in the day.
  3. A urinary tract infection (UTI) triggers a need to pee more during the day and at night but is seldom the only symptom and may be accompanied with pain, burning during the passage of urine or lower abdominal pain, fever.
  4. Older age too is related to nocturia. As we age, our body produces less of a hormone that helps concentrate urine which helps us hold urine till morning and thus there is a need to get up to pee at night.
  5. Pregnancy and childbirth weaken the bladder and pelvic floor muscles and cause frequent night time and day time urination in women.
  6. Certain medications which are given for other health problems, such as hypertension may cause one to pee more especially if taken close to bedtime. 
  7. Other medical conditions such as diabetes, prostate issues, neurological issues, and ongoing pregnancy.

Diagnosis of Nocturia-

Diagnosing the cause of nocturia can be tricky and needs a variety of investigations and a detailed questionnaire from your doctor is to be expected. It is therefore very important to maintain a diary if you have been having the problem of excessive nighttime urination for quite some time. The important point to keep noting in the diary is what you drink and how much, how often you need to urinate.

Few of the questions to be expected by your doctor are-

  1. When did the nocturia start?
  2. How many times do you have to urinate every night?
  3. Are you producing less urine than you did before?
  4. Do you have accidents or have you wet the bed?
  5. Does anything make the problem worse?
  6. Do you have any other symptoms?
  7. What medications are you taking?
  8. Do you have a family history of bladder problems or diabetes?

It is, therefore, an important thing to be prepared with information to the above questions beforehand. A few of the common tests done to rule out the causes of nocturia are- urinalysis and urine culture, blood sugar test to check for diabetes, other blood tests for blood counts and blood chemistry, imaging tests, such as ultrasounds or CT scans.

Tips to deal with nocturia-

Treatment for night time urination majorly depends on its cause and it usually resolves once its underlying cause is found out and treated.

Here are a few tips to deal with night time urination-

  1. Drink your normal amount of liquid but do so earlier in the day. Reducing the amount you drink 2 to 4 hours before bedtime can help prevent you from needing to urinate at night.
  2. Cut down on any drinks in the last two hours before you go to bed – especially alcohol, coffee or tea as these stimulate urine production. 
  3. Keep a diary of how much you drink, what you drink, and when. This may be helpful in identifying the factors or situations which cause or worsen the nocturia.
  4. Some food items can be bladder irritants, such as chocolate, spicy foods, acidic foods, and artificial sweeteners. Avoid them.
  5. Kegel exercises and pelvic floor physical therapy can help strengthen your pelvic muscles and improve bladder control.
  6. Paying attention to what worsens the symptoms is important so that you can try to modify your habits accordingly. 
  7. Take an afternoon nap- if you have been getting up frequently due to nocturia, a nap can help you feel better during the day.
  8. Avoid setting excessively low temperatures on the Air conditioner at night to avoid cold-induced diuresis.

By

Dr. Afroze Fatima

References

https://www.healthline.com/symptom/night-time-urination

https://www.webmd.com/urinary-incontinence-oab/nocturia-pee-night

https://www.sleepfoundation.org/articles/nocturia-or-frequent-urination-night

https://www.healthline.com/health/urination-excessive-at-night

https://my.clevelandclinic.org/health/diseases/14510-nocturia

 

Deciding where to deliver your baby

There are few important points you are not supposed to miss when you are near to your delivery. One among them is deciding where to deliver your baby. Usually all women go to the same treating obstetrician to deliver their babies where their antenatal checkups have been done. 

But if you are planning to deliver in different place from where you had a routine check up, you need to be a little careful in choosing the place of delivery. 

You need to see the following in a hospital when considering it as a place of delivering your baby before you join for delivery:

1.Availability of the obstetrician. Check if that hospital is your doctors home hospital or not. Check with her first to see if she does rounds at more than one location and, if so, tour both to see in which hospital she stays for a long time.

2.Availability of neonatal care unit and pediatrician is also important. Incase your baby needs some care after delivery, no need to rush to other hospital for neonatal care. 

3.Availability of good investigations department which include all  blood tests, urine tests, radiology department in the hospital.

  1. Availability of 24*7 pharmacy is a must.
  2. Check if that hospital is covered by your insurance provider and talk to them about the availability of rooms under insurance before you join.

Some more things you need to keep in mind if you are near to your delivery are:

1.Map out which hospitals are close to your home. You may need to go to the hospital quickly while you are in labor. 

2.Enquire about your doctors availability at the time of your delivery.

3.Check with your insurance company about what all you need to submit during admission

4.Don’t be alone during your delivery period. Ask anyone to stay along with you at home or when you go out.

References:

https://www.wikihow.com/Decide-Where-to-Deliver-Your-Baby

https://www.babycenter.com/0_choosing-a-hospital_1148.bc

By,

DR.Y.ALEKHYA

 

                                                                          

 

Planning your support systems especially if you are having an older child.

Even though you’ve been through pregnancy and childbirth before. Being aware of the changes to come and helping your older child understand what to expect is the best way to prepare for this joyous event.

Understand the needs of your first child before your delivery so that you can arrange all things in a systematic way.

  1. Encourage your toddler to socialize and play with other children, perhaps in a playgroup. This helps your child to develop the social skills they will need to have a good relationship with their new sibling.
  2. Take help from your elders as you cannot give attention to both of them at the same time. Explain to them about food and sleep timings, likes and dislikes of your older child to your elders so that they can take care accordingly.
  3. Remind visitors to pay attention to your older child, and not just the baby.
  4. Point out the benefits of being an older child, like choosing what to eat, being able to go to the park and play, and having friends.
  5. If you don’t have the help of elders from family, hire a nanny few months before the time of delivery so that your child and nanny get acquainted with each other

References:

https://www.babycenter.com/0_getting-care-for-your-child-during-the-birth-of-a-sibling-ov_3636618.bc

https://www.ahaparenting.com/ages-stages/pregnancy/preparing-child-separation-while-birth-new-baby

By,

Dr. Y. Alekhya

Bed wetting (Nocturnal Enuresis) – A problem for children and parents.

Even though it is very common during childhood, it should be evaluated further in case of prolonged bed wetting even after 5 years. Bed wetting occurs more commonly in boys aged 4-11 years than girls. Most of the parents think that bedwetting is due to laziness which is not the actual cause.

Causes:

Cause can be due to physical or psychosocial factors. If the child spends all day under strong pressures whether from parents or from school. Major reasons include:

  1. Stressful homelife and conflict between parents
  2. Poor daytime toilet habits
  3. Urinary tract infection
  4. Diabetes
  5. Down’s syndrome
  6. Attention deficit hyperactivity disorder
  7. Deep sleep and arousal disorder
  8. Congenital malformations of genitourinary tract
  9. Chronic constipation in which full bowel will put pressure on bladder
  10. Slow development of bladder control

Laboratory tests:

  • Urine analysis is the first step in which we check the pus cells, protein, casts and glucose to rule out urinary tract infections and renal disease.
  • Random blood sugars are checked to rule out diabetes.
  • Urine culture is based on the urine analysis report.
  • Children with complicated enuresis may need further evaluation with renal ultrasound and voiding cystourethrogram.

Treatment:

  • Reassurance is the best approach for both the child and parents.
  • Avoid punitive measures that can affect child’s psychological development adversely.
  • Fluid intake should be restricted to 60ml after 6-7pm.
  • Parents should be certain that the child voids at bedtime.
  • Avoiding sugars and caffeine after 4pm can also be helpful.
  • Waking children few hours after they go to sleep can help them to wake up dry.
  • The child should not be blamed for bed wetting.
  • Praise the child and give them a star if they wake up dry.
  • Some pharmacological measures are there to give short term relief but  can be only advised by doctors, if the above measures do not work.
  • If there is any underlying cause like diabetes or structural abnormalities, treatment is given to treat that first.

References:

https://www.webmd.com/urinary-incontinence-oab/bed-wetting-in-adults

https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
By,

Dr.Y. Alekhya.

 

Tips to deal with breast pain

Breast pain is experienced by women at some point in their lives. Sometimes, it may interfere with daily activities and cause a lot of fear and anxiety in the person suffering from it. It is therefore important to know some home remedies that can be used as basic management. If the given tips do not provide relief then it must be discussed with the doctor.

Some of the well-known and tested home remedies and tips to deal with breast pain shall be discussed.

Tips to deal with breast pain-

  1. Wear a supportive bra – it is important to find out the correct size and fitting and also use sports bra when exercising.
  2. Use less salt – especially just before your periods.
  3. Apply local heat to the painful area. During pain peaks, alternating hot and cold packs can help.
  4. Avoiding caffeine has shown a significant reduction in breast pain in women who have it often.
  5. Intake of fish oil /omega-3 supplements is found to be useful- Natural dietary sources include- dark green leafy vegetables, ocean-raised (“wild”) cold-water fish, flax, walnuts, and sesame. Omega-3 supplements are also available by prescription and over-the-counter.
  6. Vitamin E has also been helpful in reducing breast pain and therefore a short term course after consultation with your doctor can be helpful.
  7. Evening primrose oil is now widely advised for helping with breast pain.
  8. Dietary modifications such as eating a low-fat diet – is really beneficial.
  9. If you take birth control pills and seem to find aggravation in breast pain or tenderness, it is advisable to talk about it with your doctor and find out suitable alternatives.
  10. If you are overweight, then losing that excess weight with the help of regular exercise and a healthy diet can really help in the reduction of episodes of breast pain.
  11. Lower your stress levels through stress management techniques such as yoga, deep breathing exercises, etc has been shown to reduce breast pain.
  12.  Smoking can worsen breast pain, it is high time to quit smoking if you have breast pain.
  13. Stock in some pain relieving medicines after consulting your doctor if you have very serious breast pain episodes.
  14. Mild massage can help improve blood circulation and reduce inflammation and pain.
  15. Estrogen dominance in some women causes breast tenderness and pain. Eat plenty of fiber to help your body flush out extra estrogen. You can get fiber from cabbage, broccoli, sprouts, legumes, and whole grains.
  16. Drink plenty of water throughout the day to get rid of toxins from the body.
  17. Reduce your intake of hydrogenated oils, found in margarine, packaged baked goods, and snack products.

 

Other than the above-mentioned tips, it is vital for all women to examine their breasts at least once in 2-3 months and any difference in the size or shape of your breasts is felt then it is important to consult a doctor.

Written by Dr.Afroze Fatima

References-

https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423

https://www.cbhs.com.au/health-well-being-blog/blog-article/2017/08/31/breast-pain-explained

https://www.webmd.com/baby/breast-tenderness

https://www.webmd.com/women/normal-vs-abnormal-breasts#1

https://www.hopkinsmedicine.org/health/conditions-and-diseases/mastalgia-breast-pain

https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia/management-and-treatment